Individual
DR. DEBRA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1892 WILLAMETTE ST, EUGENE, OR 97401-4404
(541) 465-1885
(541) 344-4620
Mailing address
1892 WILLAMETTE ST, EUGENE, OR 97401-3383
(541) 465-1885
(541) 344-4620
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1221
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1221
STATE LICENSE NUMBER
OR
Enumeration date
05/15/2007
Last updated
12/10/2008
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