Anne Martha Jackson, RN, MN, CNS

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

200670017CNS Issued in OR

Practice address

13175 SE Kuehn Rd
Milwaukie, OR 97222-4730

Phone

(503) 970-4201

NPI assigned

Sep 2, 2014

Last updated

Sep 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1174923627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13175 SE KUEHN RD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224730",
            "telephone_number": "503-970-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13175 SE KUEHN RD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224730",
            "telephone_number": "503-970-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANNE",
        "middle_name": "MARTHA",
        "credential": "RN, MN, CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OR",
            "license": "200670017CNS",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00110808",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "099006034RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Inga Itami, DOULA
• Sonan Daba Itcha, FNP
• Jennifer Iverson
• Jaaro Massage
• Aesa Jackson, OTR
• Jennifer B Jackson
• Brenda Jacob, PTA
• Stephen Jacobsen, LAC.
• Pamela Rene Jahelka, PTA
• Daren Matthew Jahn

• Clinical Nurse Specialist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Clinical Nurse Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.