Jackson, Kathryn
Jackson, Kathryn is an sole proprietor health care provider with primary practice located at 6002 Westgate Blvd Ste 274 , Tacoma WA 98406-2571. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Jackson, Kathryn can be contacted via phone (253) 509-2960.Contact Information
Primary practice address
6002 Westgate Blvd Ste 274
Tacoma WA 98406-2571
Phone: (253) 509-2960
Fax: (306) 400-2735
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 025801 RN00121312 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | AP30003731 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | AP30003731 | Washington |
Profile Details
| NPI number | 1780661694 |
|---|---|
| LBN Legal business name | Jackson, Kathryn |
| Credentials | ARNP CNM |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 30th, 2005 |
| Last updated | Oct 24th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780661694 | NPPES |
| Washington | Other | G8895828 | MEDICARE |
| Washington | MEDICAID | 9620246 | MEDICARE |
| Washington | Other | JA7565 | MEDICARE |
| Washington | Other | 0270551 | MEDICARE |
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