Individual
KATHARINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD60462377
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780840579
—
WA
01
—
P01421059
RR MEDICARE
WA
Enumeration date
08/01/2008
Last updated
03/22/2015
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