Individual
TREVOR REID JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
541 EUREKA WAY, SEQUIM, WA 98382-5074
(360) 582-0808
(360) 682-2712
Mailing address
541 EUREKA WAY, SEQUIM, WA 98382-5074
(360) 582-0808
(360) 682-2712
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
61104032
WA
363A00000X
Physician Assistant
PA61104032
WA
363AM0700X
Medical Physician Assistant
Primary
PA61104032
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/16/2019
Last updated
04/13/2026
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