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General NPI Number Information
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NPI Number | 1942822531
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Entity Type | Individual
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Provider Name | MORGAN JACKSON MD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 1000 SE TECH CENTER DR STE 120
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City | VANCOUVER
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State | WA
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Zip | 98683-5548
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Country | US
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Telephone | 360-487-4660
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Fax | 360-487-4660
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Provider Business Mailing Address
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Address Line | 1000 SE TECH CENTER DR STE 120
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City | VANCOUVER
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State | WA
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Zip | 98683-5548
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Country | US
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Telephone | 360-487-4660
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Fax | 360-487-4670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 38163
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD61529950
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License Number State | WA
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