Individual
MRS. ALYCIA WAI LIN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9290 SE SUNNYBROOK BLVD, #120, CLACKAMAS, OR 97015-6899
(503) 215-2110
(503) 215-2115
Mailing address
9290 SE SUNNYBROOK BLVD, #120, CLACKAMAS, OR 97015-6899
(503) 215-2110
(503) 215-2115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A133720
CA
207Q00000X
Family Medicine Physician
Primary
MD180196
OR
Other
Enumeration date
05/06/2013
Last updated
02/08/2017
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