1. Home
  2. Directory
  3. Washington
  4. Taholah
  5. Counselor
  6. NPI Profile

MISHELLE JACKSON SUDPT
NPI 1053192377
Counselor - Addiction (Substance Use Disorder) in Taholah, WA

Active since October 12, 2023
1505 KLA-OOK-WA DR, TAHOLAH, WA 98587(360) 276-8215 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mishelle Jackson Sudpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISHELLE JACKSON SUDPT (NPI 1053192377) is an individual addiction (substance use disorder) provider in Taholah, Washington, licensed in Washington (CO-61267571) and active in the NPI registry since October 2023.

NPPES Registry Identity

NPI1053192377
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMISHELLE JACKSONCredential: SUDPT
Location Address1505 KLA-OOK-WA DRTaholah, WA 98587
Mailing AddressPo Box 219Taholah, WA 98587-0219 · (360) 276-8215
Phone(360) 276-8215
Sole ProprietorNo
Enumeration DateOctober 12, 2023
NPPES CertifiedOctober 10, 2023
✔ NPI 1053192377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · CO-61267571
1505 KLA-OOK-WA DR, Taholah, WA 98587
Open in Google Maps ↗

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAVEL MITIN PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
GREGORY G KOZLOWSKI DDS
Dentist (General Practice)
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
QUINAULT INDIAN NATION
Clinic/Center (Dental)
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
HOLLY ANNE MULLINS MASSAGE PRACTITIONER
Massage Therapist
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
QUINAULT CHEMICAL DEPEDENCY
Clinic/Center (Rehabilitation, Substance Use Disorder)
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
QUINAULT INDIAN NATION
Clinic/Center (Mental Health (Including Community Mental Health Center))
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
MARY LOUISE HART ARNP
Nurse Practitioner (Family)
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405
TRICIA DEE BUMGARNER MA
Massage Therapist
1505 KLA-OOK-WA DR
TAHOLAH, WA 98587
Grays Harbor County (360) 276-4405

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mishelle Jackson's NPI number?

The NPI number for Mishelle Jackson is 1053192377. It was assigned to this individual provider in the NPPES registry on October 12, 2023.

Where is Mishelle Jackson located?

Mishelle Jackson practices at 1505 Kla-Ook-Wa Dr, Taholah, WA 98587. The listed phone number is (360) 276-8215.

What is Mishelle Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mishelle Jackson was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.