Organization
RICHMOND INTERNAL MEDICINE, P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID B JACKSON M.D. (PRESIDENT)
(206) 546-5181
Entity
Organization
Contact information
Practice address
355 NW RICHMOND BEACH RD, SHORELINE, WA 98177-3101
(206) 546-5181
(206) 546-6575
Mailing address
355 NW RICHMOND BEACH RD, SHORELINE, WA 98177-3101
(206) 546-5181
(206) 546-6575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7073752
—
WA
01
—
DE7285
RAILROAD MEDICARE
WA
Enumeration date
05/12/2006
Last updated
11/05/2007
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