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Provider Detail for 1851075477
MR. JACKSON GREY LIKENS, PA-C
Gender: M
Mailing Address:
18012 68TH AVE S STE 101
KENT, WA 98032-1022
Phone: 425-291-3300
Physical Address:
3651 ASHWORTH AVE N UNIT B
SEATTLE, WA 98103-8116
Phone: 407-927-1656
Taxonomy
Physician Assistants & Advanced Practice Nursing Providers/Physician Assistant
State: FL License: 9116959
Physician Assistants & Advanced Practice Nursing Providers/Physician Assistant
(Primary Specialty)
State: WA License: PA61450103
Last Update: 04/24/2024
Provider Enrollment, Chain and Ownership System (PECOS)
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This NPI is eligible to order and refer in the Medicare program - they have a record in the PECOS database (click here for more info). |
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