NPI 1043181613

Robert Tyrone Jackson

Practitioner Peer Specialist Yakima, WA

Practice location

Address: 120 S 3rd St, Yakima, WA 98901-2875
Phone: (509) 571-1537

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence CG-70001630 (WA)

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Registry record

NPI: 1043181613
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2025
Record last updated: 16 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.