Individual provider Active NPI

Karla Lee Jackson, R.N.

  • Registered Nurse
  • Seattle, WA
National Provider Identifier
1376975698
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
00064637 Issued in WA
Practice address
8004 S 118TH St
Seattle, WA 98178-3852
Phone
(206) 772-0347
Fax
(206) 772-0374
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 00064637 WA Primary

Addresses

Primary practice location

8004 S 118TH St
Seattle, WA 98178-3852

Mailing address

8004 S 118TH St
Seattle, WA 98178-3852
Phone (206) 772-0347

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
00064637WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1376975698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8004 S 118TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783852",
            "telephone_number": "206-772-0347",
            "fax_number": "206-772-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8004 S 118TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783852",
            "telephone_number": "206-772-0347",
            "fax_number": "206-772-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KARLA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00064637",
            "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 Aug 9, 2013; 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.