Individual
MR. DAVID MYERS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, MS, MAMFT
Contact information
Practice address
685 NW 5TH ST, STE A, CORVALLIS, OR 97330-6462
(541) 757-1761
Mailing address
685 NW 5TH ST, STE A, CORVALLIS, OR 97330-6462
(541) 757-1761
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1729
OR
Other
Enumeration date
01/11/2017
Last updated
04/10/2023
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