Individual
RICHARD A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MB CHB FRCA
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 731-8386
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
TR00047636
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8471914
—
WA
Enumeration date
01/31/2007
Last updated
07/09/2007
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