Bodhi Jackson, Deshika Venezio

Bodhi Jackson, Deshika Venezio is an individual health care provider with primary practice located at 611 12Th Ave S , Seattle WA 98144-2007. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Bodhi Jackson, Deshika Venezio can be contacted via phone (206) 324-9360.

Contact Information

Primary practice address
611 12Th Ave S Seattle WA 98144-2007
Phone: (206) 324-9360
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 60997028 Washington
Behavioral Health & Social Service Providers / Clinical 1041C0700X SWI.LW.61395765 Washington
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDPT.CO.70090832 Washington

Profile Details

NPI number 1164065108
LBN Legal business name Bodhi Jackson, Deshika Venezio
Credentials MSW, LSWAIC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2019
Last updated Jul 28th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164065108 NPPES
Washington Other 60997028 DOH LSWAIC CREDENTIAL

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