Jackson, Monica

Jackson, Monica is an sole proprietor health care provider with primary practice located at 134 Se 5Th Ave Suite C, Hillsboro OR 97123-4095. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Jackson, Monica can be contacted via phone (971) 777-0756.

Contact Information

Primary practice address
134 Se 5Th Ave Suite C Hillsboro OR 97123-4095
Fax: (503) 648-5269
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1255882841
LBN Legal business name Jackson, Monica
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2016
Last updated Oct 18th, 2016 - about 9 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 1255882841 NPPES
Oregon MEDICAID 278095

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