National Provider Identifier Database

TARA JACKSON, CPO – NPI #1851255764
Prosthetist

An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both


Contact Information

TARA JACKSON, CPO
1274 CONGRESS ST
PORTLAND, ME04102-2111
Phone: 207-774-1002
Fax:
Website:
Specialty Taxonomy Code
* Prosthetist 224P00000X

* Indicates primary specialty

NPI Profile & details for TARA JACKSON

NPI Number 1851255764
Credentials CPO
Entity Individual
Enumeration date 12/15/2025
Last updated 12/15/2025 - About 6 months ago
Sole proprietor1 No
Identifiers
  • ME License #: CPO04857
Hospital affiliation n/a

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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