Individual
KIMBERLEY JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 588-5351
Mailing address
12200 SW HORIZON BLVD, #208, BEAVERTON, OR 97007-9329
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
02/16/2007
Last updated
08/20/2009
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