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LYDIA BURR JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
8844 BENSON RD, LYNDEN, WA 98264-9787
(360) 318-0260
(360) 318-0261
Mailing address
226 SE 8TH AVE, HILLSBORO, OR 97123-4218
(503) 601-7400
(503) 601-7311

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61495995
WA
363AM0700X
Medical Physician Assistant
PA01417
OR

Other

Enumeration date
11/25/2008
Last updated
06/06/2024
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