Individual provider · Type 1 NPI

Raymond Jackson

Student in an Organized Health Care Education/Training Program · Shaker Heights, OH

NPI number 1154048213 Active

Practice location

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819

Call (216) 932-2800 Map

Fax (216) 932-6704

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XC.2507148-TRNE (OH)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1154048213

Raymond Jackson's National Provider Identifier is 1154048213, issued on Oct 20, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Shaker Heights, OH. The record was last updated on Sep 18, 2025.