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MICHAEL R. JACKSON, M.D., P.S.

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Company Details

Legal Name: MICHAEL R. JACKSON, M.D., P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: November 7th 2011
Date of Dissolution: April 3rd 2023
Expiration date: 30 Nov 2022
UBI Number: 603 157 444
ZIP code: 98467
City: University Place
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 5350 ORCHARD ST W. SUITE 202, SUITE 202, UNIVERSITY PLACE, WA, 98467, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 5350 ORCHARD ST W STE 202, UNIVERSITY PL, WA, 98467-4817, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $6,569

Contact Details

E-Mail: MJACKSONMD@ICLOUD.COM
Phone Number: +1 253-472-4444

Nature of Business

Health Care, Social Assistance & Service Organization

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Key Officers & Management

Name Role
PAULA JACKSON Governing Person
MICHAEL REID JACKSON Governing Person

National Provider Identifier

NPI Number:
1366701849

Authorized Person:

Name:
MICHAEL R JACKSON
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

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