MRS. GWENDOLYN MERITA JACKSON (NPI# 1588011035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588011035 |
| Entity Type | Individual |
| Full Name | MRS. GWENDOLYN MERITA JACKSON |
| Credential | PA-C |
| Practice Address |
10400 Ne 4th St Ste 2250 Bellevue WA 98004-5186 |
| Mailing Address |
1 Embarcadero Ctr Ste 1900 San Francisco CA 94111-3723 |
| Practice Telephone | 4252741003 |
| Practice Fax Number | 2062379075 |
| Mailing Telephone | 4156586791 |
| Mailing Fax Number | 4156586791 |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2019-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60796452 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952735391 | Gwendolyn Faye Jackson | Nurse's Aide | 5743 Farwell Dr., Houston, TX 77035 | 2013-08-21 |
| 1417244286 | Gwendolyn Sandra Jackson | Social Worker | 2514 Gates Cir Apt 12, Baton Rouge, LA 70809-1017 | 2011-06-30 |
| 1780144683 | Gwendolyn Michelle Jackson | Chore Provider | 2860 E Flamingo Rd Ste K, Las Vegas, NV 89121-5270 | 2019-03-25 |
| Street Address |
10400 NE 4TH ST STE 2250 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-5186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881643666 | Stacie Elizabeth Maurer | Internal Medicine | 10400 Ne 4th St Ste 2250, Bellevue, WA 98004-5174 | 2006-05-09 |
| 1992169262 | Jessica Lujan | Nurse Practitioner | 10400 Ne 4th St Ste 2250, Bellevue, WA 98004-5186 | 2016-04-12 |
| 1962838516 | Jana Soltero | Physician Assistant | 10400 Ne 4th St Ste 2250, Bellevue, WA 98004-5186 | 2013-09-15 |
| 1134140171 | Odhett M Cojocaru | Internal Medicine | 10400 Ne 4th St Ste 2250, Bellevue, WA 98004-5186 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538557442 | Mariam Abdelghany I | Physician Assistant | 2500 Bellevue Medical Center Drive, Bellevue, NE 68123 | 2014-12-30 |
| 1174899017 | Amber Tario Gudas | Physician Assistant | 1414 116th Ave Ne Ste E, Bellevue, WA 98004-3801 | 2012-03-26 |
| 1003103565 | Stefany Jeneifer Cameron | Physician Assistant | 1750 112th Ave Ne Ste D050, Bellevue, WA 98004 | 2011-07-06 |
| 1770746505 | Erik H Suh Md Ps | Physician Assistant | 2100 116th Ave Ne, Bellevue, WA 98004 | 2008-07-02 |
| 1700099736 | Michelle M Berlin | Physician Assistant | 2206 Longo Dr Ste 107, Bellevue, NE 68005-2977 | 2007-05-07 |
| 1164569315 | Kristeen Lee Budreau | Physician Assistant | 6639 161st Ave Se, Unit B, Bellevue, WA 98006-5687 | 2007-01-30 |
| 1013012491 | Joseph A. Stangl | Physician Assistant | 3802 Raynor Pkwy, Bellevue, NE 68123-6048 | 2006-09-13 |
| 1528088952 | Patricia L Lightfoot | Physician Assistant | 1135 116th Ave Ne Ste 560, Bellevue, WA 98004-4631 | 2006-07-20 |
| 1831176395 | Anthony Aaron Meador | Physician Assistant | 15585 Ne 24th St, Bellevue, WA 98007-3836 | 2005-12-27 |
| 1255338166 | Earl R Thompson | Physician Assistant | 3308 Samson Way, Bellevue, NE 68123-3234 | 2005-07-07 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.