Individual
KAREN GAIL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
377 NW JASPER ST, DALLAS, OR 97338-1279
(503) 623-5581
Mailing address
3470 BALD EAGLE DR, LEBANON, OR 97355-1871
(541) 979-8683
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8845
OR
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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