Individual
MRS. MELINDA ANN JACKSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-6556
(503) 215-0685
Mailing address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-6556
(503) 215-0685
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD12772
OR
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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