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JUDY JACKSON
NPI 1407569718
Licensed Practical Nurse in Portland, OR

Active since January 02, 2023
745 NE 122ND AVE, PORTLAND, OR 97230(503) 252-0241 Get Directions Write a Review

NPPES record last updated: January 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Judy Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUDY JACKSON (NPI 1407569718) is an individual licensed practical nurse in Portland, Oregon, licensed in Oregon (201408689LPN) and active in the NPI registry since January 2023.

NPPES Registry Identity

NPI1407569718
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameJUDY JACKSON
Location Address745 NE 122ND AVEPortland, OR 97230-2001
Mailing Address745 Ne 122nd AvePortland, OR 97230-2001
Phone(503) 252-0241
Sole ProprietorNo
Enumeration DateJanuary 2, 2023
NPPES CertifiedJanuary 2, 2023
✔ NPI 1407569718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OR · 201408689LPN
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
745 NE 122ND AVE, Portland, OR 97230
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Other Identifiers 1

Other000000OR · None Obtained

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE J KIM
Physical Therapist
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (502) 252-0241
IGNACIO HIDALGO
Physical Therapy Assistant
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241
HUCKLEBERRY TM KOESTER SLP
Speech-Language Pathologist
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241
JENNIFER REDMAN LPN
Licensed Practical Nurse
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241
MENLO PARK SNF HEALTHCARE LLC
Skilled Nursing Facility
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241
DR. AARON R. PROCTOR OTD
Community Health Worker
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241
BEVERLY LYNN BRUNO BSN, RN, IPC
Registered Nurse (Infection Control)
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241
DARLENE GAYHEART RN
Registered Nurse (General Practice)
745 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 252-0241

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Judy Jackson's NPI number?

The NPI number for Judy Jackson is 1407569718. It was assigned to this individual provider in the NPPES registry on January 2, 2023.

Where is Judy Jackson located?

Judy Jackson practices at 745 NE 122nd Ave, Portland, OR 97230. The listed phone number is (503) 252-0241.

What is Judy Jackson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Judy Jackson was last updated on January 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.