Individual
LYDIA GAIL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, MS
Contact information
Practice address
3410 CHERRY AVE NE, KEIZER, OR 97303-4924
(503) 602-8384
Mailing address
2691 VINTAGE AVE SE, SALEM, OR 97306-2534
(503) 881-3098
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
04/12/2026
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