NPI 1093473092
Thomas D Jackson
Practice location
- Address
- 612 Woodland Square Loop SE STE 401, Lacey, WA 98503-1070
- Phone
- (360) 763-5828
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1093473092
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 7 Dec 2021
- Record last updated
- 7 Dec 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.