Brian James Jackson
Oral and Maxillofacial Pathology
3924 Martin Way E
Olympia
, Washington 98506-5220
Brian James Jackson
Oral and Maxillofacial Pathology
3924 Martin Way E
Olympia
, Washington 98506-5220
(360) 493-8179
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Brian James Jackson
- 3924 Martin Way E
- Olympia, WA
- Zip : 98506-5220
- Fax : (360) 493-8179
- Phone : (360) 456-8610
Second Address
- Brian James Jackson
- 3924 Martin Way E
- Olympia, WA
- Zip : 98506-5220
- Fax : (360) 493-8179
- Phone : (360) 456-8610
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 6128 | WA |
National Provider Identifier
| NPI | 1770655979 |
|---|---|
| Provider Name | Brian James Jackson |
| First Address | Olympia, WA 98506-5220 |
| Second Address | Olympia, WA 98506-5220 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/11/2006 |
| Last Update Date | 07/10/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5030374 | (05) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.