{"npi":"1194255877","type":"NPI-1","status":"active","name":{"display":"Andrea Jackson PHD","other":[],"first":"ANDREA","last":"JACKSON","middle":"MARIE","credential":"PHD"},"specialty":{"primary_taxonomy":"103T00000X","primary_taxonomy_description":"Psychologist","slug":"psychologist","schema_org_specialty":null,"all":[{"code":"103T00000X","description":"Psychologist","primary":true,"state":"OR","license":"3120"}]},"addresses":[{"purpose":"LOCATION","street_1":"170 MELTON RD","city":"CRESWELL","state":"OR","postal_code":"974269453","country_code":"US","phone":"5413066456"},{"purpose":"MAILING","street_1":"170 MELTON RD","city":"CRESWELL","state":"OR","postal_code":"974269453","country_code":"US","phone":"5413066456"}],"license":{"state":"OR","number":"3120"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20190905003099","type_code":"14-68","type_desc":"PRACTITIONER - CLINICAL PSYCHOLOGIST","state":"OR","pac_id":"7719216431"}]},"enumeration_date":"2017-06-15","last_updated":"2024-10-30","_meta":{"source":"NPPES","snapshot_date":"2024-10-30","doc_url":"https://findmynpi.com/api"}}