Individual
EUNICE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(844) 870-1183
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(844) 870-1183
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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