Kimmisha Jackson Royal

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

61492022 Issued in WA

Practice address

9600 Veterans Dr SW
Tacoma, WA 98493-6638

Phone

(253) 582-8440

Fax

(253) 589-4143

NPI assigned

Dec 18, 2023

Sex

Female

Sole proprietor

No

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": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1679341762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 18TH AVENUE CT S APT R14",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984446638",
            "telephone_number": "253-355-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984936638",
            "telephone_number": "253-582-8440",
            "fax_number": "253-589-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON ROYAL",
        "first_name": "KIMMISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "61492022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Dale Howard, M.D.
• Benjamin James Jabara, MD
• Jomel Patrick Lee Jacinto, DO
• Daniel R. Jack, M.D.
• Jackson County Dialysis
• Ami Jackson, DO
• Arleen A Jackson, LPN
• Brittany Victoria Jackson
• Christina Jackson, LAC
• Deborah Olivia Jackson

• Licensed Practical Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.