Active NPI
Andrew Jackson
- Naturopath
- Seattle, WA
National Provider Identifier
1285177253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- NT60704271
- Practice address
- 12025 Lake City Way NE Ste B
Seattle, WA 98125-5331 - Phone
- (860) 916-4708
- NPI assigned
- Nov 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | NT60704271 | WA | Primary |
Addresses
Primary practice location
12025 Lake City Way NE Ste B
Seattle, WA 98125-5331
Mailing address
12025 Lake City Way NE Ste B
Seattle, WA 98125-5331
Phone (860) 916-4708
Other practice location 1
547 Dayton St
Edmonds, WA 98020-3431
Phone (425) 563-6780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NT60704271 | WA | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cynthia Keller MD | Past | Accepting new patients | |
| Centered in Wellness, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Non-Pharmacy Dispensing Site
- Kirkland, WA
- NPI 1467842161
-
- Pediatrics Physician
- Kirkland, WA
- NPI 1225436512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1285177253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12025 LAKE CITY WAY NE STE B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981255331",
"telephone_number": "860-916-4708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12025 LAKE CITY WAY NE STE B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981255331",
"telephone_number": "860-916-4708"
}
],
"practiceLocations": [
{
"address_1": "547 Dayton St",
"address_purpose": "LOCATION",
"city": "Edmonds",
"state": "WA",
"postal_code": "980203431",
"country_code": "US",
"telephone_number": "425-563-6780",
"fax_number": "425-670-2807",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-23",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "WA",
"license": "NT60704271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.