Lydia Michelle Jackson

Primary specialty

DoulaTaxonomy code 374J00000X

License

111668 Issued in OR

Practice address

2800 N Vancouver Ave
Portland, OR 97227-1630

Phone

(503) 413-4500

NPI assigned

Oct 21, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1174344287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N VANCOUVER AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271630",
            "telephone_number": "503-413-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3136 SE 136th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972362800",
            "country_code": "US",
            "telephone_number": "971-895-5485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LYDIA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "OR",
            "license": "111668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly L Jackson
• Lashaunda Louise Jackson
• Laura Marie Jackson, FNP, CWCN
• Laurie Jackson, CADC
• Lloyd Chris Jackson, MCM, CADC I, CRM II
• Mallori A Jackson
• Melinda Ann Jackson
• Melissa T Jackson, MS HUMAN SERVICES
• Michelle Jackson, M.S., OTR/L
• Natalie Jo Jackson

• Doula in Portland, OR
• Providers in Portland, OR by specialty
• Doula in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.