Individual
ANNE MARTHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MN, CNS
Contact information
Practice address
13175 SE KUEHN RD, MILWAUKIE, OR 97222-4730
(503) 970-4201
Mailing address
13175 SE KUEHN RD, MILWAUKIE, OR 97222-4730
(503) 970-4201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
00110808
WA
163W00000X
Registered Nurse
099006034RN
OR
364S00000X
Clinical Nurse Specialist
Primary
200670017CNS
OR
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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