Grant W Jackson Md Ps | |
319 E Pioneer Ave Montesano WA 98563-4601 | |
(360) 249-1980 | |
Not Available |
Full Name | Grant W Jackson Md Ps |
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Speciality | Family Medicine |
Location | 319 E Pioneer Ave, Montesano, Washington |
Authorized Official Name and Position | Grant Jackson (DIRECTOR) |
Authorized Official Contact | 3602491980 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grant W Jackson Md Ps 319 E Pioneer Ave Montesano WA 98563-4601 Ph: (360) 249-1980 | Grant W Jackson Md Ps 319 E Pioneer Ave Montesano WA 98563-4601 Ph: (360) 249-1980 |
NPI Number | 1023274370 |
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Provider Enumeration Date | 08/05/2008 |
Last Update Date | 08/05/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023274370 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD60002207 (Washington) | Primary |
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