Individual
MARY S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559-0528
(907) 543-6300
(907) 543-6366
Mailing address
49 AIRPORT ROAD, KWETHLUK, AK 99621
(907) 757-6627
(907) 757-6626
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/02/2013
Last updated
05/12/2017
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