Individual
YOLANDA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
1817 NE 6TH AVENUE, PORTLAND, OR 97212-3906
(503) 719-7985
(503) 944-5262
Mailing address
1817 NE 6TH AVENUE, PORTLAND, OR 97212-3906
(503) 719-7985
(503) 944-5262
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-CRM-1546
OR
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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