Andrea Marie Jackson, PhD
Psychologist in Creswell, OR. Individual provider (NPI-1).
NPI number1194255877
StatusActive
Last updated in NPPESOct 30, 2024
Details
- NPI
- 1194255877
- Entity type
- Individual (NPI-1)
- Name
- Andrea Marie Jackson
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2017
- Certification date
- Oct 30, 2024
- Last updated
- Oct 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 3120 | OR | Yes |
Practice location
170 Melton RdCreswell, OR 97426-9453
Phone 541-306-6456
Mailing address
170 Melton RdCreswell, OR 97426-9453
Phone 541-306-6456
Other practice locations
534 Pleasant View Way Nw Ste 200
Albany, OR 97321-1789
Albany, OR 97321-1789
Phone 541-812-5760
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