Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164065108 Individual Practitioner Female Practitioner

Deshika Venezio Bodhi Jackson , MSW, LSWAIC

Social Worker • Seattle, WA

Professional Overview & Biography Verified Profile Summary

Deshika Bodhi Jackson, MSW, LSWAIC is a registered healthcare professional specializing in Social Worker in Seattle, WA. Practice services are available at 611 12TH AVE S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

611 12th Ave S

Seattle, WA 981442007

Telephone 2063249360
Associated Practice Facility / Clinic
🏢 Seattle Indian Health Board Facility NPI 1497820542

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Seattle, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.2 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
476 Specialists

Practicing in Seattle, WA (2183 Statewide)

Telehealth Adoption Rate
0.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-28
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

State License WA 60997028

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.

Social Worker - Clinical

NUCC Taxonomy Code: 1041C0700X

State License WA SWI.LW.61395765

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License WA CDPT.CO.70090832

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Doh Lswaic Credential
60997028 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Adrian Bailey , LH

Counselor - Mental Health

NPI 1013207703
NPI 1023085495

Doctor of Medicine (M.D.)

Dr. Colleen D'amico , PharmD

Pharmacist - Ambulatory Care

NPI 1053894519

Doctor of Pharmacy (Pharm.D.)

Beverly Price , LPN

Licensed Practical Nurse

NPI 1063177855

Licensed Practical Nurse

Dr. Hong Phuc Le , PharmD

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI 1063836419

Doctor of Pharmacy (Pharm.D.)

Shawna Gallagher , MSW

Social Worker - Clinical

NPI 1083885818

Master of Social Work

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
👤
Provider Name / Credentials Updated May 13, 2026

Recorded as DESHIKA BODHI JACKSON, MSW, LSWAIC

📍
Updated Practice Location May 07, 2026

Registered at 611 12TH AVE S, SEATTLE, WA 981442007 (Tel: 2063249360)

📍
Updated Business Mailing Address May 07, 2026

Registered at 611 12TH AVE S, SEATTLE, WA 981442007 (Tel: 2063249360)

📍
Updated Practice Location September 03, 2021

Registered at 13925 INTERURBAN AVE S STE 120, TUKWILA, WA 981685726 (Tel: 2064374415)

📍
Updated Business Mailing Address September 03, 2021

Registered at 13925 INTERURBAN AVE S STE 120, TUKWILA, WA 981685726 (Tel: 2064374415)

NPI Profile Active October 22, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location October 22, 2019

Registered at 316 BROADWAY, SEATTLE, WA 981225325 (Tel: 2063790992)

📍
Updated Business Mailing Address October 22, 2019

Registered at 4230 THACKERAY PL NE, SEATTLE, WA 981056544 (Tel: 2063790992)

👤
Provider Name / Credentials Updated October 22, 2019

Recorded as DESHIKA PERERA, MSW, LSWAIC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 22, 2019

Social Worker (License #60997028 in WA)

🟢
Initial NPI Registration & Enumeration October 22, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1164065108
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 22, 2019
Last Update: July 28, 2026
Sole Proprietor: No

Mailing Address

611 12th Ave S

Seattle, WA 981442007

Phone: 2063249360

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.