Jackson, Garrick D

Jackson, Garrick D is an individual health care provider with primary practice located at 2545 N Eldorado Ave , Klamath Falls OR 97601-6423. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Jackson, Garrick D can be contacted via phone (541) 883-3471.

Contact Information

Primary practice address
2545 N Eldorado Ave Klamath Falls OR 97601-6423
Phone: (541) 883-3471
Fax: (541) 883-3524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X A2147 Oregon

Profile Details

NPI number 1124287594
LBN Legal business name Jackson, Garrick D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2008
Last updated Feb 16th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124287594 NPPES
Oregon MEDICAID 090450

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