Individual
DAVID B JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 E MANITOBA AVE, STE 101, ELLENSBURG, WA 98926-3885
(509) 925-6100
(509) 925-7604
Mailing address
700 E MANITOBA AVE, STE 101, ELLENSBURG, WA 98926-3885
(509) 925-6100
(509) 925-7604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00025572
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046358
—
WA
01
—
P00312050
RAILROAD MEDICARE
WA
Enumeration date
12/09/2005
Last updated
01/21/2014
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