Healthcare Provider Details

I. General information

NPI: 1851210546
Provider Name (Legal Business Name): JASPER HEALING PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 BROADWAY STE 104A
TACOMA WA
98402-3786
US

IV. Provider business mailing address

708 BROADWAY STE 104A
TACOMA WA
98402-3786
US

V. Phone/Fax

Practice location:
  • Phone: 253-540-6182
  • Fax: 253-540-6183
Mailing address:
  • Phone: 253-540-6182
  • Fax: 253-540-6183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DARIAN HAWKE
Title or Position: PRACTICE OWNER
Credential: DNP
Phone: 253-540-6182