Individual
DUANE L JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
28815 PACIFIC HWY S STE 2, FEDERAL WAY, WA 98003-3876
(253) 941-7074
(253) 941-5079
Mailing address
28815 PACIFIC HWY S STE 2, FEDERAL WAY, WA 98003-3876
(253) 941-7074
(253) 941-5079
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00002039
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120065
LABOR AND INDUSTRIES
WA
05
—
2015139
—
WA
Enumeration date
04/17/2007
Last updated
07/29/2008
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