Deonka Shaney Jackson, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60907224 Issued in WA

Practice address

1519 28TH St NW
Puyallup, WA 98371-3770

Phone

(832) 293-2584

NPI assigned

Nov 21, 2018

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

Other names 1

• Ms. Deonka Shaney Ceaser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1447729223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 28TH ST NW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983713770",
            "telephone_number": "832-293-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 28TH ST NW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983713770",
            "telephone_number": "832-293-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DEONKA",
        "middle_name": "SHANEY",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111873",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60907224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEONKA",
            "last_name": "CEASER",
            "middle_name": "SHANEY",
            "prefix": "MS.",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather R Izzi, LMP
• J. Michaelson, Jr. M.D. Facog, P.S.
• J. Perry Ormiston, D.D.S., M.S.D., P.S.
• Erin A Jackowski, OT
• Andrew James Jackson
• Kyra Jackson
• Mackenzie Nicole Jackson, PT, DPT
• Brooke Jacobs
• Catrina M Jacobs
• Jane E Jacobs, M.S

• Speech-Language Pathologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.