JACKY KINGSADA NP NPI 1538867882

NPI Information

  • NPI: 1538867882
  • Provider Name: JACKY KINGSADA, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 195 NE GILMAN BLVD STE 200
    ISSAQUAH, WA
    ZIP 98027
  • Phone: (253) 204-9386

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NPI Details

Jacky Kingsada, NP is a family nurse practitioner in Issaquah, WA with 2 years of experience. Jacky Kingsada, NP NPI is 1538867882. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

195 NE GILMAN BLVD STE 200
ISSAQUAH, WA
ZIP 98027-940
Phone: (253) 204-9386

The NPI 1538867882 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 enumeration date for this NPI number is 2/16/2023 and was last updated on 2/18/2023.

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
1363LF0000XNurse PractitionerFamilyAP61412255WASHINGTONYes

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: 3/30/2025

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