Individual
LORA K JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
243511 HIGHWAY 101, PORT ANGELES, WA 98363-9472
(360) 452-6252
Mailing address
243511 HIGHWAY 101, PORT ANGELES, WA 98363-9472
(360) 452-6252
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60347928
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61059916
WA
Other
Enumeration date
03/23/2016
Last updated
02/07/2022
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