Individual
SUSAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1629 N 45TH ST, SEATTLE, WA 98103-6701
(206) 633-3350
(206) 633-3113
Mailing address
905 SPRUCE ST, STE. 300, SEATTLE, WA 98104-2474
(206) 461-6935
(206) 461-8382
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004068
WA
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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