Mackenzie Nicole Jackson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61528942 Issued in WA

Practice address

11212 Sunrise Blvd E Ste 202
Puyallup, WA 98374-8847

Phone

(253) 435-0360

Fax

(253) 435-0325

NPI assigned

Sep 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group
• Physiotherapy Associates, Inc.

  • Physical Therapist
  • Kirkland, WA
  • NPI 1497211049
  Medicare reassignment NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD
• Trishard P.C.

  • Rehabilitation Clinic/Center
  • Warren, MI
  • NPI 1992793442
  NPD (past)

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1356955751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11212 SUNRISE BLVD E STE 202",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748847",
            "telephone_number": "253-435-0360",
            "fax_number": "253-435-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 SUNRISE BLVD E STE 202",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748847",
            "telephone_number": "253-435-0360",
            "fax_number": "253-435-0325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "552 S Paseo Dorotea Ste 4",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922641437",
            "country_code": "US",
            "telephone_number": "760-325-5950",
            "fax_number": "760-325-5945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MACKENZIE",
        "middle_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019681",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61528942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Perry Ormiston, D.D.S., M.S.D., P.S.
• Erin A Jackowski, OT
• Andrew James Jackson
• Deonka Shaney Jackson, MS CCC-SLP
• Kyra Jackson
• Brooke Jacobs
• Catrina M Jacobs
• Jane E Jacobs, M.S
• William Charles Jacobs, FNP
• Charles D Jacobson, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.