Jackson S Horsley, M.D.
Individual provider Active NPI Emergency Medicine Physician · Ellensburg, WA
NPI 1770514028 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1770514028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD00017261 (WA)
- Practice address
- 603 S Chestnut St
Ellensburg, WA 98926-3875 - Phone
- (509) 962-9841
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00017261 | WA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kittitas County Hospital Dist 2 | Past | Accepting new patients | |
| Lourdes Hospital LLC | Past | Accepting new patients | |
| Northwest Physician Associates, Apc | Emergency Medicine | Past | Accepting new patients |
| Kittitas County Public Hosp Dist 1 | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00017261 | WA | Yes |
Addresses
Primary practice location
603 S Chestnut St
Ellensburg, WA 98926-3875
Mailing address
505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180
Other providers in Ellensburg, WA
- Hope and Harmony Nutrition, PLLC
- Hope Counseling and Therapy, PLLC
- Mason Jeremiah Hope
- Hopesource
- Roberta Lynn Hoppe
- Kyle Howard
- Abbey Howell
- Delaney Scout Huck
- Sonja H Huebner
- Terri Lee Hughes
All providers in Ellensburg, WA · Emergency Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.