NPI 1851255764

Tara Jackson, CPO

Practitioner Prosthetist Portland, ME

Practice location

Address: 1274 Congress St, Portland, ME 04102-2111
Phone: (207) 774-1002

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence CPO04857 (ME)

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Registry record

NPI: 1851255764
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Dec 2025
Record last updated: 15 Dec 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.