Jackson, Robert Dale

Jackson, Robert Dale is an individual health care provider with primary practice located at 4311 11Th Ave Ne Ste 200 , Seattle WA 98105. He recently has 3 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Phlebotomy, Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Jackson, Robert Dale can be contacted via phone (206) 616-4001.

Contact Information

Primary practice address
4311 11Th Ave Ne Ste 200 Seattle WA 98105
Phone: (206) 616-4001
Fax: (206) 616-3889
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Phlebotomy 246RP1900X PC60573205 Washington
Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other 246Z00000X MR60568577 Washington
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1881076230
LBN Legal business name Jackson, Robert Dale
Credentials PA-S
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2015
Last updated Aug 29th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881076230 NPPES
Washington Other MR60568577 WASHINGTON STATE LICENSE

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