| Nisha Jackson PC | |
|
1700 Nw Garden Valley Blvd Ste 201 Roseburg OR 97471-1636 | |
| (541) 930-8545 | |
| Not Available |
| Full Name | Nisha Jackson PC |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1700 Nw Garden Valley Blvd Ste 201, Roseburg, Oregon |
| Authorized Official Name and Position | Karissa Stults (VP OF BILLING AND CONTRACTING) |
| Authorized Official Contact | 5419308545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nisha Jackson PC 2040 Commerce Dr Medford OR 97504-9744 Ph: (541) 930-8545 | Nisha Jackson PC 1700 Nw Garden Valley Blvd Ste 201 Roseburg OR 97471-1636 Ph: (541) 930-8545 |
| NPI Number | 1629920442 |
|---|---|
| Provider Enumeration Date | 02/12/2026 |
| Last Update Date | 07/23/2026 |
| Certification Date | 07/23/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629920442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (NU) | Primary |
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