Individual
ROBERT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2525 PORTLAND ST, EUGENE, OR 97405-3153
(541) 515-6321
(541) 515-6195
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
04/03/2023
Last updated
10/05/2023
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