Peggy Ann Jackson-Oman

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60680388 Issued in WA

Practice address

14692 179TH Ave SE
Monroe, WA 98272-1198

Phone

(360) 804-2500

NPI assigned

Oct 19, 2021

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

State licenses

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1558024380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7311 59TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708883",
            "telephone_number": "360-658-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14692 179TH AVE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721198",
            "telephone_number": "360-804-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-OMAN",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60680388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Rehabilitation Group, PC
• Kelly Rae Irwin, DMD
• Jessica Isono, PHARM.D.
• Siri Eiko Ito, MD
• Maryann Ivons, N.D.
• Calvin Jackson
• Carol Joy Jacob, MA, LMHC
• Christina Jacobs, MS
• Marianne D Jacobson, P.C.D C.L.E G.S.C
• Sulayman Jagne

• Speech-Language Pathologist in Monroe, WA
• Providers in Monroe, 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 19, 2021; 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.