TERESA L JACKSON (NPI# 1700982444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700982444 |
| Entity Type | Individual |
| Full Name | TERESA L JACKSON |
| Practice Address |
17880 147th St Se Monroe WA 98272-1014 |
| Practice Telephone | 3607941405 |
| Practice Fax Number | 3607941493 |
| Mailing Telephone | 3607941405 |
| Mailing Fax Number | 3607941493 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2019-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
MD60822145 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | HEALTHNET | 2Z1286 | 01 |
| AZ | 851685 | 05 | |
| AZ | BLUE CROSS BLUE SHIELD | AZ0789290 | 01 |
| WA | 2099880 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336485390 | Teresa Jackson | Rehabilitation Practitioner | 2244 Revere St, North Las Vegas, NV 89030-4011 | 2012-12-19 |
| 1972865442 | Teresa Alice Jackson | Contractor | 41 Green St, Valley Stream, NY 11580-4815 | 2012-06-11 |
| 1477881696 | Teresa Danielle Jackson | Chiropractor | 5304 Panola Industrial Blvd Ste E, Decatur, GA 30035-4065 | 2009-11-29 |
| 1831317528 | Teresa B. Jackson | Pharmacist | Lower Level Reynolds Gym Wingate Road, Lower Level Reynolds Gym Wingate Road, Winston-salem, NC 27109 | 2007-04-20 |
| 1649744343 | Teresa M Jackson | Counselor | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2019-01-15 |
| 1306372842 | Teresa Lynne Jackson | Nurse Practitioner | 3450 N Rock Rd Ste 503, Wichita, KS 67226-1355 | 2017-05-03 |
| 1558780478 | Teresa Jackson | Spec/Tech, Pathology | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2014-04-08 |
| 1245582741 | Teresa B Jackson | Audiologist-Hearing Aid Fitter | 2001 Lincoln Dr W, Suite E, Marlton, NJ 08053-1531 | 2012-10-08 |
| 1194001677 | Teresa Leigh Jackson | Nurse Practitioner | 222 22nd Ave N, Suite 400, Nashville, TN 37203 | 2011-10-27 |
| 1700016300 | Teresa C Jackson | Nurse Practitioner | 2780 Bob Wallace Ave Sw, Huntsville, AL 35805-4104 | 2009-07-17 |
| Street Address |
17880 147TH ST SE |
| City | MONROE |
| State | WA |
| Zip Code | 98272-1014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447883483 | Melissa Beth Mitchell | Registered Nurse | 17880 147th St Se, Monroe, WA 98272-1014 | 2020-02-18 |
| 1760791958 | James A Dauer | Counselor | 17880 147th St Se, Suite 201, Monroe, WA 98272-1014 | 2010-10-05 |
| 1215252606 | David Lee Anderson | Counselor | 17880 147th St Se, Monroe, WA 98272-1014 | 2010-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710346135 | Kiran Agarwal | Internal Medicine | 17707 W Main St Fl 1, Monroe, WA 98272 | 2016-02-12 |
| 1982073136 | Rochelle Conway Toulouse | Behavioral Analyst | 642 North Street, Monroe, WA 98272 | 2015-09-17 |
| 1740658467 | Casey Jane Bahr | Social Worker | Casey Bahr, C.o. Tru- Sotap, 16550 177th Ave Se, Monroe, WA 98272 | 2015-09-11 |
| 1811395049 | Gianna M Rosewood | Massage Therapist | 101 East Main Street Set 201, Monroe, WA 98272 | 2014-12-22 |
| 1528478609 | Puget Sound Kidney Centers | Clinic/Center | 18121 149th Street Se, Monroe, WA 98272 | 2014-04-29 |
| 1215356878 | Sabiha K Barot | Emergency Medicine | Evergreenhealth Monroe, 14701 179th Ave. Se, Monroe, WA 98272 | 2014-04-10 |
| 1346677986 | Irina Emily Goldstein | Pharmacist | 179th Ave Se, Monroe, WA 98272 | 2013-09-27 |
| 1740612449 | Erik Michael Erxleben | Massage Therapist | 211 West Hill St., Monroe, WA 98272 | 2013-08-05 |
| 1780023796 | Jamie Marlo Selbe | Counselor | 16560 167th St Se, Monroe, WA 98272 | 2013-06-24 |
| 1942644620 | Robin Fenn | Counselor | 14841 179th Ave Se, St 230, Neary Naturopathic Clinic, Monroe, WA 98272 | 2013-04-24 |
| Find all providers in zip 98272 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073549002 | John D Patz | Family Medicine | 14841 179th Ave Se, Suite 210, Monroe, WA 98272-1127 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194342162 | Bicycle Health Medical Group Pa | Family Medicine | 1700 Westlake Ave N Ste 200, Seattle, WA 98109-6212 | 2020-06-25 |
| 1134748643 | Workit Health Mi Pllc | Family Medicine | 4505 Pacific Hwy E Ste C2, Fife, WA 98424-2638 | 2020-04-14 |
| 1508322363 | Heal From Addiction, LLC | Family Medicine | 7 S Howard St Ste 210, Spokane, WA 99201-3816 | 2019-02-18 |
| 1366953630 | Ideal Option, Pllc | Family Medicine | 8921 E Alki Ave Ste 1, Spokane Valley, WA 99212-2705 | 2017-10-13 |
| 1962928200 | E & H Holdings, LLC | Family Medicine | 708 E Penn St, Moses Lake, WA 98837 | 2017-08-18 |
| 1851816409 | Ideal Option, Pllc | Family Medicine | 406 Se 131st Ave Ste 104, Vancouver, WA 98683-4031 | 2017-08-04 |
| 1467903054 | Ideal Option, Pllc | Family Medicine | 1725 Continental Pl, Ste C, Mount Vernon, WA 98273-5693 | 2016-10-18 |
| 1912395211 | Consistent Care Services Spc, Ps | Family Medicine | 1612 4th St, Suite 200, Marysville, WA 98270-5045 | 2015-01-08 |
| 1558685925 | Central Washington Sleep Diagnostic Center, Pllc | Family Medicine | 2323 W Broadway Ave Ste 4, Moses Lake, WA 98837 | 2010-03-15 |
| 1497081855 | Jsn Inc | Family Medicine | 1135 Ellis St, Bellingham, WA 98225-5246 | 2009-10-20 |
| Find all providers with the same taxonomy | ||||
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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.