Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DESHIKA VENEZIO BODHI JACKSON MSW, LSWAIC
NPI 1164065108
Social Worker in Seattle, WA

Q: What is Deshika Bodhi Jackson's NPI number?

The NPI number for Deshika Bodhi Jackson is 1164065108. It was assigned to this individual provider in the NPPES registry on October 22, 2019. The provider is also known as Deshikia Venezio Bodhi-Jackson.

Q: What is Deshika Bodhi Jackson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Active since October 22, 2019PECOS Enrolled

611 12TH AVE S, SEATTLE, WA 98144(206) 324-9360 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 28, 2026, May 13, 2026, May 7, 2026 and 1 more (4 updates tracked since 2019).

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About Deshika Venezio Bodhi Jackson Msw, Lswaic NPPES

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

DESHIKA VENEZIO BODHI JACKSON MSW, LSWAIC (NPI 1164065108) is an individual social worker in Seattle, Washington, licensed in Washington (60997028) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164065108

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameDESHIKA VENEZIO BODHI JACKSONCredential: MSW, LSWAIC

Location Address611 12TH AVE SSeattle, WA 98144-2007

Mailing Address611 12th Ave SSeattle, WA 98144-2007 · (206) 324-9360

Phone(206) 324-9360

Sole ProprietorNo

Enumeration DateOctober 22, 2019

Last NPPES UpdateJuly 28, 20264 updates tracked since enumeration

NPPES CertifiedJuly 28, 2026

✔ NPI 1164065108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in WA · 60997028

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CDPT.CO.70090832 (WA)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License SWI.LW.61395765 (WA)

611 12TH AVE S, Seattle, WA 98144

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Other Names 1

Other Name (5)Deshikia Venezio Bodhi-jackson

Other Identifiers 1

Other60997028WA · Doh Lswaic Credential

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deshika Venezio Bodhi Jackson Msw, Lswaic 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 20

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

ADRIAN MARGARET BAILEY LH

Counselor (Mental Health)

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 324-9360

CHRISTOPHER H GAYNOR MD

Family Medicine

611 12TH AVE S, SUITE 200
SEATTLE, WA 98144

King County (206) 324-9360

MS. ROBERTA L FLETCHER CDP

Counselor (Addiction (Substance Use Disorder))

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 834-4029

COLLEEN OLIVIA D'AMICO PHARMD

Pharmacist (Ambulatory Care)

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 324-9360

BEVERLY PRICE LPN

Licensed Practical Nurse

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 324-9360

HONG PHUC THI LE PHARM.D

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 324-9360

MRS. SHAWNA FAY GALLAGHER M.S.W

Social Worker (Clinical)

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 324-9360

KAROL LEA PARKER MSW

Social Worker (Clinical)

611 12TH AVE S
SEATTLE, WA 98144

King County (206) 324-9360

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 Deshika Bodhi Jackson's NPI number?

The NPI number for Deshika Bodhi Jackson is 1164065108. It was assigned to this individual provider in the NPPES registry on October 22, 2019. The provider is also known as Deshikia Venezio Bodhi-Jackson.

Where is Deshika Bodhi Jackson located?

Deshika Bodhi Jackson practices at 611 12th Ave S, Seattle, WA 98144. The listed phone number is (206) 324-9360.

What is Deshika Bodhi Jackson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Deshika Bodhi Jackson enrolled in Medicare?

Yes. Deshika Bodhi Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Deshika Bodhi Jackson was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.