Jackson Sanguily, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.PA.70147889 Issued in WA

Practice address

413 29TH St NE Ste I
Puyallup, WA 98372-7154

Phone

(855) 255-1750

Fax

(855) 255-0905

NPI assigned

May 21, 2024

Last updated

Jul 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• United Wound Healing Accountable Care Consultants PLLC

  • Surgery Physician
  • Puyallup, WA
  • NPI 1881337632

  Physician Assistant

  NPD (past)
• United Wound Healing PS

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Puyallup, WA
  • NPI 1669845327

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1548009343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24081",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240081",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 29TH ST NE STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983727154",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3827 N Lafayette St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055089",
            "country_code": "US",
            "telephone_number": "303-500-1518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANGUILY",
        "first_name": "JACKSON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-21",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.PA.70147889",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA.PA.70147889",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA.PA.70147889",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CO",
            "license": "Q212354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah C Sanders
• Sarah Sanderson
• Kamalneel Kaur Sandhu
• Rana Sandhu, PA-C
• Jaspreet Kaur Sangha
• Jessica Santana
• Mikynna Mychael Santos, CERTIFIED BT
• Mary Santovito
• Saomalie Fa'Ase Saole, BA
• Jerica Lorraine Sapp, LMT

• Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.