NPI 1053917567

Selena Jackson

Practitioner Community Health Worker Ketchikan, AK

Practice location

Address: 2434 Fourth Ave, Ketchikan, AK 99901-5820
Phone: (907) 225-7825
Mailing address: 721 Stedman St, Ketchikan, AK 99901-6632

Registered specialties (2)

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X

Other Community Health Worker providers in Alaska →

Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Alaska →

Registry record

NPI: 1053917567
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Dec 2020
Record last updated: 9 Feb 2021

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.