OrganizationActive
Nisha Jackson Inc.
NPI 1629920442 · Rural Health Clinic/Center · Roseburg, OR
Provider details
- NPI number
- 1629920442
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Karissa Stults, Vp of Billing and Contracting(541) 930-8545
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1700 Nw Garden Valley Blvd Ste 201
Roseburg, OR 97471-1636
Phone: (541) 930-8545
Approximate (ZIP-level) locationGet directions
Mailing address
2040 Commerce Dr
Medford, OR 97504-9744
Registry dates
- Enumerated
- 2026-02-12
- Last updated
- 2026-02-12
- Certified
- 2026-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.