Jackson, Christopher

Jackson, Christopher is an individual health care provider with primary practice located at 10000 Se Main St Ste 316, Portland OR 97216-2448. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jackson, Christopher can be contacted via phone (503) 256-1575.

Contact Information

Primary practice address
10000 Se Main St Ste 316 Portland OR 97216-2448
Phone: (503) 256-1575
Fax: (503) 253-9848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00019884 Washington
Allopathic & Osteopathic Physicians / Surgery 208600000X MD166621 Oregon

Profile Details

NPI number 1669429700
LBN Legal business name Jackson, Christopher
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Apr 8th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669429700 NPPES
Washington MEDICAID 8539900

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