PETER JACKSON

PORTLAND, OR
NPI1598054132
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RP1001X Internal Medicine, Pulmonary Disease
(Licence: OR  MD170303)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
207RC0200X Internal Medicine, Critical Care Medicine
(Licence: OR  MD170303)
Enumeration Date2011-04-05
Last Update Date2017-05-12
Business Address
-- PETER JACKSON M.D.
2222 NW LOVEJOY ST #411
PORTLAND, OR 97210-3033
Phone number: 503-413-5702
Mailing Address
-- PETER JACKSON M.D.
2222 NW LOVEJOY ST #411
PORTLAND, OR 97210-3033
Phone number: 503-413-5702