Selena Jackson, is a
Community Health Worker based in Ketchikan, Alaska. Selena Jackson is licensed to practice in * (Not Available) (license number ) and her current practice location is
2434 Fourth Ave, Ketchikan, Alaska. She can be reached at her office (for appointments etc.) via phone at
(907) 225-7825.
NPI number for Selena Jackson is 1053917567 and her current mailing address is 721 Stedman St, Ketchikan, Alaska. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1053917567.
Healthcare Provider's Profile
Full Name | Selena Jackson |
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Gender | Female |
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Speciality | Community Health Worker |
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Location | 2434 Fourth Ave, Ketchikan, Alaska |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1053917567
- Provider Enumeration Date: 12/09/2020
- Last Update Date: 02/09/2021
Medical Identifiers
Medical identifiers for Selena Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053917567 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Selena Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Selena Jackson, 721 Stedman St, Ketchikan, AK 99901-6632 Ph: (907) 225-7825 | Selena Jackson, 2434 Fourth Ave, Ketchikan, AK 99901-5820 Ph: (907) 225-7825 |
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