Individual
CORINNA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10690 NE CORNELL RD STE 315, HILLSBORO, OR 97124-9224
(503) 352-0468
Mailing address
10690 NE CORNELL RD STE 315, HILLSBORO, OR 97124-9224
(503) 352-0468
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202214795NP-PP
OR
Other
Enumeration date
07/17/2015
Last updated
09/21/2022
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