KELLY COLLEEN JACKSON


Address: 811 Madison St, Everett, WA 98203-4543
Phone: 4252124200

KELLY COLLEEN JACKSON (NPI# 1629544655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629544655
Entity Type Individual
Full Name KELLY COLLEEN JACKSON
Credential CDPT
Practice Address 811 Madison St
Everett
WA 98203-4543
Mailing Address Po Box 2569
Everett
WA 98213-0569
Practice Telephone 4252124200
Practice Fax Number 4252124201
Mailing Telephone 4252124200
Mailing Fax Number 4252124201
Enumeration Date 2018-10-17
Last Update Date 2019-05-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
CO60869651 WA Behavioral Health & Social Service Providers

Other Providers KELLY JACKSON

NPI Name Taxonomy Address Enumeration
1588036263 Kelly Jackson Social Worker 2937 Ne 16th Ter, Gainesville, FL 32609-3234 2015-10-21
1477896876 Kelly A Jackson Occupational Therapist 178 Manila Ave, Staten Island, NY 10306-5608 2013-04-03
1104986793 Kelly A Jackson Chiropractor 190 North Main Street, Natick, MA 01760 2006-12-12
1518982487 Kelly Donald Jackson Dentist 3023 Eastland Blvd Ste 112, Clearwater, FL 33761-4106 2006-07-13
1689273310 Kelly Jackson Behavior Technician 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5312 2020-10-23
1619457926 Kelly Jackson Physician Assistant 12300 Mccracken Rd, Garfield Heights, OH 44125-2975 2018-08-16
1760961833 Kelly D Jackson Licensed Practical Nurse 602 W Semands St, Conroe, TX 77301-1867 2018-08-09
1841780178 Kelly Amanda Jackson Nurse Practitioner 1700 Medical Center Pkwy, Murfreesboro, TN 37129-2245 2018-05-11
1033653431 Kelly Jackson Nurse Practitioner 606 W Columbia St, San Augustine, TX 75972-1709 2016-12-05
1497108310 Kelly Jackson Massage Therapist 1325 San Marco Blvd, Suite 102, Jacksonville, FL 32207-8568 2016-07-15

Office Location

Street Address 811 MADISON ST
City EVERETT
State WA
Zip Code 98203-4543

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932140985 Sondra Lee Laverne Counselor 811 Madison St, Everett, WA 98203-4543 2006-06-09
1891394623 Raymond Francis Lacko Jr. Counselor 811 Madison St, Everett, WA 98203-4543 2020-10-22
1356940480 Dennis R Phillips Counselor 811 Madison St, Everett, WA 98203-4543 2020-10-20
1285243956 Lauran Elizabeth Tapp Counselor 811 Madison St, Everett, WA 98203-4543 2020-07-28
1154930147 Alexa T Nachreiner Counselor 811 Madison St, Everett, WA 98203-4543 2020-07-27
1134738222 Jonathan Thomas Wallis Counselor 811 Madison St, Everett, WA 98203-4543 2020-07-24
1659998417 Corilynne Woods Counselor 811 Madison St, Everett, WA 98203-4543 2020-06-28
1942825781 Lauren F Wilson Counselor 811 Madison St, Everett, WA 98203-4543 2020-06-08
1669096913 Meghan Irene Rose White Counselor 811 Madison St, Everett, WA 98203-4543 2020-06-02
1285257790 Susan Sarrazin Counselor 811 Madison St, Everett, WA 98203-4543 2020-05-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083226039 Lisa Mcgregor Counselor Sea Mar Community Health Centers, 5007 Claremont Way, Everett, WA 98203 2020-08-20
1417572009 Megan Ostermick-durkee Student in an Organized Health Care Education/Training Program Sunrise Services Inc., 811 Madison Street, Everett, WA 98203 2020-06-10
1134741424 Tara Lin Garcia Peer Specialist 4256 Federal Avenue, Everett, WA 98203 2020-05-11
1225505241 Reverie Aurora Shunny Counselor Sunrise Service Inc., 811 Madison Street, Everett, WA 98203 2018-10-29
1205313483 Kristina Renee Bylenga Counselor Compass Health 4526 Federal Avenue M/s # 11, Everett, WA 98203 2018-07-20
1306384300 Shantijoy Inc Naturopath 5208 S 2nd Ave, Everett, WA 98203 2017-02-09
1922545276 Ekaterina Malinovska Dds Pllc Dentist 5920 Evergreen Way Suite E, Everett, WA 98203 2017-01-25
1326404104 Job Oichoe Counselor 4625 Federal Ave, Everett, WA 98203 2016-01-08
1427423292 Ross Lee Voorhees Counselor 4423 S 3rd Ave, Everett, WA 98203 2015-12-04
1447642376 Adam Schneider Counselor 4526 Federal Ave # 40, Everett, WA 98203 2015-03-02
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1124664172 Deidre Michelle Greene Counselor 13105 21st Dr Se Apt E307, Everett, WA 98208-7173 2019-11-25
1356859623 Victor Cleveland Counselor 10315 19th Ave Se Ste 112, Everett, WA 98208-4268 2018-01-19
1386155893 Kristin Zarrello Counselor 11008 20th Dr Se, Everett, WA 98208-5241 2017-10-24
1861927949 Melanie Schmidt Counselor 2610 Westmore Ave, Everett, WA 98201 2017-04-26
1619401973 David Alexander Counselor 10905 3rd Ave Se, Everett, WA 98208-7020 2017-04-13
1982152955 Adekunbi Afusat Olukoya Counselor 8625 Evergreen Way Ste 108, Everett, WA 98208-2647 2016-09-19
1588012694 Tammy J Laird Counselor 9300 Evergreen Way, Everett, WA 98204 2016-05-31
1902269418 Clay Eakin Counselor 2732 Grand Evenue, Everett, WA 98208 2016-04-01
1891157798 Pamela Hubbard Counselor 3501 Colby Ave Ste 105, Everett, WA 98201-4795 2016-03-22
1881052280 Jolene Eva Janacek Counselor 1811 Mcdougall Ave, Everett, WA 98201-2456 2016-02-01
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Competitor

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City EVERETT
Zip Code 98203

Improve Information

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Dataset Information

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.

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