Individual
TAMARA E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
201 16TH AVE E, SEATTLE, WA 98112-5226
(206) 326-3000
Mailing address
201 16TH AVE E, SEATTLE, WA 98112-5226
(206) 326-3000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8392045
—
WA
Enumeration date
12/27/2006
Last updated
07/23/2024
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