NISHA JACKSON INC NPI 1275485088

NPI Information

  • NPI: 1275485088
  • Provider Name: NISHA JACKSON, INC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Address: 2590 WOODLAND DR
    COOS BAY, OR
    ZIP 97420
  • Phone: (541) 217-2022

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NPI Details

NISHA JACKSON, INC is a rural health clinic center in Coos Bay, OR. NISHA JACKSON, INC NPI is 1275485088. The provider is registered as an organization entity type.

The provider's business location address is:

2590 WOODLAND DR
COOS BAY, OR
ZIP 97420-050
Phone: (541) 217-2022

The provider's authorized official is Karissa Stults .
The authorized official title is Vp Of Billing And Contracting and has the following contact phone number (541) 930-8545.

The enumeration date for this NPI number is 2/12/2026 and was last updated on 2/12/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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