Individual
MELANIE A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3615 NW SAMARITAN DR STE 110, CORVALLIS, OR 97330-3756
(541) 768-7900
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD193502
OR
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
MD193502
OR
Other
Enumeration date
06/26/2013
Last updated
01/03/2023
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