Individual
ZACHARY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
23008 56TH AVE W, MOUNTLAKE TERRACE, WA 98043-4754
(425) 678-6008
Mailing address
1821 25TH AVE E, SEATTLE, WA 98112-3007
(206) 504-4096
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P1.60984193
WA
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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