IndividualActive
Calvin Jackson
NPI 1053701003 · Massage Therapist · Monroe, WA
Provider details
- NPI number
- 1053701003
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- MA60431582 (WA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
101 E Main St
Ste 201
Monroe, WA 98272-1519
Phone: (360) 863-0642
Fax: (360) 794-7236
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 14072
Mill Creek, WA 98082-2072
Registry dates
- Enumerated
- 2015-01-29
- Last updated
- 2015-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.