Jackson, Lisa A

Jackson, Lisa A is an individual health care provider with primary practice located at 1730 Minor Ave , Seattle WA 98101-1498. She recently has only one registered license in Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine, which is considered as her primary health care specialty. Jackson, Lisa A can be contacted via phone (206) 442-5216.

Contact Information

Primary practice address
1730 Minor Ave Seattle WA 98101-1498
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X MD00027646 Washington

Profile Details

NPI number 1639299290
LBN Legal business name Jackson, Lisa A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Sep 30th, 2009 - about 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639299290 NPPES
Washington MEDICAID 8342040

Popular Providers