Individual
DR. KREYTON DIRK JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
279 SW 10TH ST, ONTARIO, OR 97914-2135
(541) 889-2020
(541) 889-9675
Mailing address
279 SW 10TH ST, ONTARIO, OR 97914-2135
(541) 889-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3357AT
OR
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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