Judith Lynn Jackson

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

2820 N Cherry St Apt C105
Spokane Valley, WA 99216-5009

Phone

(509) 413-2792

NPI assigned

Sep 4, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1114575016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N CHERRY ST APT C105",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165009",
            "telephone_number": "509-413-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N CHERRY ST APT C105",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165009",
            "telephone_number": "509-413-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JUDITH",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Michael Itveldt, MSN
• Blessing Iwuozo
• J Blake, DMD, PS
• Taylor Jacklin, LMP
• Holly Jackson, PHARMD
• Lauren Ann Jackson
• Michael Frederick Jackson, LMT
• N Scott Jackson, PA-C
• Noah Jackson
• Amber Rose Jacober, SUDPT

• Attendant Care Provider in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Attendant Care Provider in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.