MR. JACKSON WATSON NPI 1124696653

NPI Information

  • NPI: 1124696653
  • Provider Name: MR. JACKSON WATSON
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 19020 33RD AVE W STE 210
    LYNNWOOD, WA
    ZIP 98036
  • Phone: (425) 563-1500

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NPI Details

MR. Jackson Watson is a medical physician assistant in Lynnwood, WA with 5 years of experience. MR. Jackson Watson NPI is 1124696653. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MERCER UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2021

The provider's business location address is:

19020 33RD AVE W STE 210
LYNNWOOD, WA
ZIP 98036-748
Phone: (425) 563-1500
Fax: (425) 563-1374

The NPI 1124696653 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)
  • Initial hospital inpatient care per day, typically 30 minutes (HCPCS:99221)
  • Insertion of non-tunneled central venous tube for infusion (5 years or older) (HCPCS:36556)

The enumeration date for this NPI number is 6/11/2021 and was last updated on 11/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA61438621WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12254430MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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