Doroteya J Jackson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61596226 Issued in WA

Practice address

4730 University Way NE Ste 104
Seattle, WA 98105-4424

Phone

(833) 777-2500

NPI assigned

Oct 17, 2024

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conscious Reset PLLC

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1689496366
  NPD Authorized official
• Northwest Chiropractic, Inc.

  • Chiropractor
  • Federal Way, WA
  • NPI 1295855567
  NPD

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1306667878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 UNIVERSITY WAY NE STE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 UNIVERSITY WAY NE STE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054424",
            "telephone_number": "833-777-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DOROTEYA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61596226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin K Jackson
• Carla R Jackson
• Cassandra E Jackson, M ED, LMHC
• Catherine M Jackson, PAC
• Chelsea W Jackson, ARNP
• Douglass Jackson, DMD
• Edward I Jackson Sr.
• Elaine Ruth Jackson
• Elaine Yi-Ling Jackson, M.ED., CCC-SLP
• Emily C Jackson, CRNA

• Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.