Grant W Jackson Md Ps

NPI 1023274370 - Family Medicine - 207Q00000X

NPI Details
NPI 1023274370
Enumeration Date 08/05/2008
Last Updated 08/05/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name GRANT GRANT
Position DIRECTOR
Phone (360) 249-1980
Fax
Practice Location
319 E PIONEER AVE
MONTESANO WA, 98563-4601, US
Phone (360) 249-1980
Fax
Business Location
319 E PIONEER AVE
MONTESANO WA, 98563-4601, US
Phone (360) 249-1980
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Washington
License Number MD60002207
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According to our database, Grant W Jackson Md Ps NPI is 1023274370, taxonomy code is 207Q00000X and license number is MD60002207, license state is located at Washington. Grant W Jackson Md Ps physically located at 319 E Pioneer Ave, Montesano WA, 98563-4601. NPI Number 1033115704 has the healthcare provider type.

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1023274370 NPI number is provided on an as is basis without warranty of any kind. 1023274370 is maintained by the National Plan & Provider Enumeration System. The contents of Grant W Jackson Md Ps are for informational purposes only.