Donald L Jackson, PA C Valid NPI
Individual provider · Physician Assistant · Kettle Falls, WA
- NPI
- 1073501177
- Type
- Individual (Type 1)
- Primary specialty
- Physician Assistant
- Specialty group
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy code
- 363A00000X
- License number
- PA10001811 (WA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2005-10-12
- Last updated
- 2014-10-28
Practice location
840 S Meyers St
Kettle Falls, WA 99141
(509) 738-6607