Individual
JEFFREY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
(206) 461-3614
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00147216
WA
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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