Selena Jackson, in Ketchikan, AK - Community Health Worker

Selena Jackson, is a Community Health Worker based in Ketchikan, Alaska. Selena Jackson is licensed to practice in * (Not Available) (license number ) and her current practice location is 2434 Fourth Ave, Ketchikan, Alaska. She can be reached at her office (for appointments etc.) via phone at (907) 225-7825.

NPI number for Selena Jackson is 1053917567 and her current mailing address is 721 Stedman St, Ketchikan, Alaska. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1053917567.

Contact Information

	Selena Jackson,
	2434 Fourth Ave, Ketchikan, AK 99901-5820
	(907) 225-7825
	Not Available

Healthcare Provider's Profile

Full Name	Selena Jackson
Gender	Female
Speciality	Community Health Worker
Location	2434 Fourth Ave, Ketchikan, Alaska
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1053917567
Provider Enumeration Date: 12/09/2020
Last Update Date: 02/09/2021

Medical Identifiers

Medical identifiers for Selena Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053917567	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
172V00000X	Community Health Worker	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Selena Jackson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Selena Jackson, 721 Stedman St, Ketchikan, AK 99901-6632 Ph: (907) 225-7825	Selena Jackson, 2434 Fourth Ave, Ketchikan, AK 99901-5820 Ph: (907) 225-7825

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Selena Jackson, - Counselor in Ketchikan, AK