Individual provider Active NPI

Michele Allyn Jackson, CNM, ARNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Kirkland, WA
National Provider Identifier
1346228376
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
AP30006675 Issued in WA
Practice address
12303 NE 130TH LN
Suite 500
Kirkland, WA 98034-3099
Phone
(425) 899-4455
Fax
(425) 899-4434
NPI assigned
Jan 9, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X AP30006675 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN
Suite 500
Kirkland, WA 98034-3099

Mailing address

7622 66TH PL NE
Marysville, WA 98270-6593
Phone (360) 658-8791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000946 WA Practitioner - Certified Nurse Midwife (CNM) 4082808316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
AP30006675WAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Feb 20, 2019 Accepting new patients
King County Public Hospital District No 2 CurrentSince Feb 20, 2019 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients
Center for Womens Health at Evergreen Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12303 NE 130th Ln
Ste 500
Kirkland, WA 98034
Phone (425) 899-4280

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1346228376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7622 66TH PL NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982706593",
            "telephone_number": "360-658-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN",
            "address_2": "SUITE 500",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343099",
            "telephone_number": "425-899-4455",
            "fax_number": "425-899-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELE",
        "middle_name": "ALLYN",
        "name_prefix": "Ms.",
        "credential": "CNM, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WA",
            "license": "AP30006675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.