Stephanie Lynn Jackson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

31955 State Route 20 Ste 3
Oak Harbor, WA 98277-5211

Phone

(360) 279-9000

NPI assigned

Nov 14, 2018

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1508335936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 NE HARVEST DR",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775912",
            "telephone_number": "360-672-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31955 STATE ROUTE 20 STE 3",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775211",
            "telephone_number": "360-279-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island of Hope Counseling PLLC
• Island Prosthodontics
• Island Speech Language & Rehabilitation, Inc.
• Mary Katherine Jackson, RN
• Sara Elizabeth Jackson
• Jennifer L Jacobs, LMT
• James Joseph Jacowski III, ARNP
• Jane Ann Jaehning, PT
• Christina Lee Jahncke, MD
• Steven Lloyd James

• Behavior Technician in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.