Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GRANT WELLS JACKSON, MD
ActiveGRANT WELLS JACKSON, MD is a Family Medicine healthcare provider located in MONTESANO, Washington. NPI 1306901475 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · MONTESANO, WA
Registration Details
- NPI Number
- 1306901475
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 27, 2006 (19.449766620239 yrs)
- Last Updated
- Aug 4, 2008
- Licenses
-
ML002797 (PA)ML002797 (PA)MD60002207 (WA)
Practice Information
- Address
-
319 E PIONEER AVEGRANT W JACKSON MD PSMONTESANO, WA, 985634601Browse WA providers · Browse ZIP 98563
- Phone
- 3602491980
- Fax
- 3602491993
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in MONTESANO, WA
| Name | Credential | NPI |
|---|---|---|
| LYNDA BRADY STAFFORD | DO | 1629021852 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.