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KASEY JOHANNA JACKSON MD
NPI 1073317731
Student in an Organized Health Care Education/Training Program in Tacoma, WA

Active since April 02, 2025PECOS Enrolled
1717 S J ST # MS 01-125, TACOMA, WA 98405(253) 552-8690 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kasey Johanna Jackson Md NPPES

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

KASEY JOHANNA JACKSON MD (NPI 1073317731) is an individual student in an organized health care education/training program in Tacoma, Washington and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073317731
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKASEY JOHANNA JACKSONCredential: MD
Location Address1717 S J ST # MS 01-125Tacoma, WA 98405-4933
Mailing Address1717 S J St # Ms 01-125Tacoma, WA 98405-4933 · (253) 552-8690
Phone(253) 552-8690
Sole ProprietorYes
Enumeration DateApril 2, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1073317731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1717 S J ST # MS 01-125, Tacoma, WA 98405
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Other Names 1

Former Name (1)Kasey Johanna Temple

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kasey Johanna Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 15

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

MYSHELLE WILLIAMS
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (509) 954-1243
KRYSTAL THAO NGUYEN DO
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (503) 553-9879
YORDANOS ELALA MD
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (253) 426-4101
DUNG MY DO DO
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (253) 552-8690
PARIA KARBASSI NAJAFABADI DO
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (253) 552-8690
JOSEPH PETERSON DO
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (253) 552-8690
BRIAN LU MD
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (808) 462-9936
JOEL ARMANIE BERVELL MD
Student in an Organized Health Care Education/Training Program
1717 S J ST # MS 01-125
TACOMA, WA 98405
Pierce County (253) 552-8690

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 Kasey Jackson's NPI number?

The NPI number for Kasey Jackson is 1073317731. It was assigned to this individual provider in the NPPES registry on April 2, 2025. The provider is also known as Kasey Johanna Temple.

Where is Kasey Jackson located?

Kasey Jackson practices at 1717 S J St # Ms 01-125, Tacoma, WA 98405. The listed phone number is (253) 552-8690.

What is Kasey Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kasey Jackson enrolled in Medicare?

Yes. Kasey Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kasey Jackson was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.