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Search › Oregon › 101YM0800X

Michael Jackson

NPI 1962647107 · on the registry since 2008

Practice

Address
8495 Crater Lake Hwy
White City, OR 97503
Phone
(541) 826-2111
Organisation at this address
Va
Vasorcc
White City Vamc
White City Vamc
White City Cboc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
220

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Licence states on file
NULL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-10-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon