IndividualActive
Nicole Jackson, DO
NPI 1508188343 · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Olympia, WA
Provider details
- NPI number
- 1508188343
- Entity type
- Individual
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- License
- OP60418108 (WA)
Specialties & taxonomies
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianPrimary208G00000XLicense OP60418108 (WA)
Allopathic & Osteopathic Physicians
Practice location
525 Lilly Rd Ne Ste 200
Olympia, WA 98506
Phone: (360) 493-4510
Fax: (360) 493-7759
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3360
Portland, OR 97208-3360
Registry dates
- Enumerated
- 2010-02-21
- Last updated
- 2018-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.