Individual
MR. JACKSON WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61438621
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2254430
—
WA
Enumeration date
06/11/2021
Last updated
11/21/2023
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