Individual
CHRISTOPHER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10000 SE MAIN ST, STE 316, PORTLAND, OR 97216-2448
(503) 256-1575
(503) 253-9848
Mailing address
10000 SE MAIN ST, STE 316, PORTLAND, OR 97216-2448
(503) 256-1575
(503) 253-9848
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD00019884
WA
208600000X
Surgery Physician
Primary
MD166621
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8539900
—
WA
Enumeration date
05/27/2006
Last updated
04/08/2015
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