MR. MICHAEL BEN JACKSON (NPI# 1720199839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720199839 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL BEN JACKSON |
| Practice Address |
925 Adele Ave Bremerton WA 98312-3521 |
| Mailing Address |
220 Ne Larson Lake Rd Belfair WA 98528-9404 |
| Practice Telephone | 3607820129 |
| Practice Fax Number | 3603778029 |
| Mailing Telephone | 3607820129 |
| Mailing Fax Number | 3603778029 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP30003880 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295345346 | Michael Frederick Jackson | Massage Therapist | 12702 E 33rd Ct, Spokane Valley, WA 99206-8372 | 2020-08-04 |
| 1295372993 | Michael Jackson | Chiropractor | 5216 Cold Springs Way, Eugene, OR 97405-5213 | 2019-12-02 |
| 1801365382 | Michael Jackson | Durable Medical Equipment & Medical Supplies | 5537b N Glenwood St Ste B, Garden City, ID 83714-1336 | 2018-11-14 |
| 1114441375 | Michael Frank Jackson Jr. | Physical Therapist | 1806 Russell Pkwy Ste 1400, Warner Robins, GA 31088-5781 | 2017-07-31 |
| 1457809931 | Michael Jackson | Counselor | 10001 W. Grand Avenue, Franklin Park, IL 60131 | 2016-09-14 |
| 1639625833 | Michael Jackson | Counselor | 128 Mute Swan Place, Newark, DE 19711 | 2016-08-28 |
| 1467823104 | Michael Jackson | Occupational Therapy Assistant | 1913 N Oakes St Apt D, Tacoma, WA 98406-7527 | 2015-10-07 |
| 1831576651 | Michael Howard Jackson | Family Medicine | 4646 Nw Fielding Road, Topeka, KS 66618 | 2015-04-30 |
| 1063809846 | Michael Jackson | Social Worker | 43518 Champlain Ct, Canton, MI 48188-1711 | 2015-04-20 |
| 1780922872 | Michael A Jackson | Pharmacist | 585 Mcwilliams Rd Se Unit 2303, Atlanta, GA 30315-7571 | 2013-01-23 |
| Street Address |
925 ADELE AVE |
| City | BREMERTON |
| State | WA |
| Zip Code | 98312-3521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326024860 | Douglas A Janachek | Pharmacist | 925 Adele Ave, Bremerton, WA 98312-3521 | 2005-12-16 |
| 1477043271 | Andrew Philip Paves | Psychologist | 925 Adele Ave, Bremerton, WA 98312 | 2018-05-16 |
| 1780048249 | Carrie Holtzman | Psychologist | 925 Adele Ave, Bremerton, WA 98312-3521 | 2016-04-11 |
| 1841610052 | Grant Phillip Shulman | Psychologist | 925 Adele Ave, Bremerton, WA 98312 | 2014-04-27 |
| 1124345178 | Seta Ghazarian | Social Worker | 925 Adele Ave, Bremerton, WA 98312-3521 | 2010-04-30 |
| 1518049006 | Patricia A Taylor | Registered Nurse | 925 Adele Ave, Bremerton, WA 98312-3521 | 2006-10-20 |
| 1194817122 | Naser H Oria | General Practice | 925 Adele Ave, Vaoc Bremerton, Bremerton, WA 98312 | 2006-09-28 |
| 1487766721 | Shelly Irene Dannen | Pharmacist | 925 Adele Ave, Bremerton, WA 98312-3521 | 2006-08-31 |
| 1174632905 | Maya Jean Wilson | Social Worker | 925 Adele Ave, Bremerton, WA 98312-3521 | 2006-08-29 |
| 1649282617 | Terese M Schneider | Nurse Practitioner | 925 Adele Ave, Bremerton, WA 98312 | 2006-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962025114 | Candace Mckenzie | Counselor | 2564 Cascades Pass Blvd, The Landings Bldg. 779, Bremerton, WA 98312 | 2020-05-22 |
| 1710473590 | Sandra Louise Walker | Family Medicine | 14301 Nw Coho Run, Bremerton, WA 98312 | 2018-07-05 |
| 1467947663 | Jason David Alexander | Military Health Care Provider | Uss Kentucky, Ssbn, Fpo, AE 98312 | 2018-06-29 |
| 1588176614 | Institute Family for Development | Community/Behavioral Health | 5610 Kitsap Way, Suite 315, Bremerton, WA 98312 | 2017-10-30 |
| 1720521321 | Debra Lynn Lemieux | Counselor | 5762 Chico Way Nw, Bremerton, WA 98312 | 2016-11-30 |
| 1164840047 | Amber Rose Morison | Chiropractor | 3963 Sand Dollar Road West, Bremerton, WA 98312 | 2014-03-28 |
| 1942625611 | Kristen Williams | Clinic/Center | 5112 Nw Taylor Rd., Bremerton, WA 98312 | 2014-03-04 |
| 1184049629 | Tariku Tsegaye Messele | Specialist/Technologist | 5112 Nw Taylor Road, Bremerton, WA 98312 | 2014-02-20 |
| 1063784064 | Johnson Chiropractic Clinic | Clinic/Center | 3721 Kitsap Way Suite #8, Bremerton, WA 98312 | 2012-02-06 |
| 1194013532 | Casey Mccann | Student in an Organized Health Care Education/Training Program | 1 Boone Rd., Naval Hospital Bremerton, Bremerton, WA 98312 | 2011-07-19 |
| Find all providers in zip 98312 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912386459 | Shannon Paris | Nurse Practitioner | 1945 Trenton Ave, Bremerton, WA 98310-5047 | 2015-05-28 |
| 1427474790 | Northwest Psychiatry Inc Ps | Nurse Practitioner | 2528 Wheaton Way Ste 204, Bremerton, WA 98310-3305 | 2014-03-11 |
| 1487936241 | Karen S Casseday | Nurse Practitioner | 1740 Ne Riddell Rd Ste 110, Bremerton, WA 98310 | 2011-09-16 |
| 1629266366 | Travis Armond Damico | Nurse Practitioner | 5002 Kitsap Way Ste 200, Bremerton, WA 98312-2359 | 2007-10-09 |
| 1578670303 | Donna L Poole | Nurse Practitioner | 5455 Almira Dr Se, Bremerton, WA 98311-8330 | 2006-08-25 |
| 1396211413 | Erin Mcmanus | Nurse Practitioner | 5455 Almira Dr Ne, Bremerton, WA 98311-8330 | 2018-10-16 |
| 1376972737 | Stanford Call | Nurse Practitioner | 5455 Almira Dr Ne, Bremerton, WA 98311-8330 | 2013-11-06 |
| 1851733729 | Lisa Pratt | Nurse Practitioner | 5455 Almira Dr Ne, Bremerton, WA 98311-8330 | 2013-07-22 |
| 1144544867 | Sharon Penny Lynne Ishihara | Nurse Practitioner | 2508 Wheaton Way, Bremerton, WA 98310-3303 | 2010-03-24 |
| 1073610325 | Jolene M. Culbertson | Nurse Practitioner | 2520 Cherry Ave, Bremerton, WA 98310-4229 | 2006-09-20 |
| Find all providers in BREMERTON | ||||
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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.