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Contact Information

SHANETTE JACKSON
602 FRONTAGE ROAD, STE.206
KENAI, AK99611
 Phone: 907-416-8276
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Massage Therapist

225700000X
Indicates primary specialty

NPI Profile & details for SHANETTE JACKSON · (Female)

NPI Number 1073045050
Status Active
Credentials
Entity Individual
Enumeration date 03/30/2017
Last updated 04/15/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • AK License # 128047
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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