Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacy C Nelson DDS, P.s.

Organization Dentist · NPI 1154878668

Jacy C Nelson DDS, P.s. is a Dentist in Renton, Washington. Licensed in Washington. Registered with an NPI since 2016.

Licensed in
WA
In the registry since
2016

Practice location Address checks out

14300 SE Petrovitsky Rd
Renton, WA 98058-8955
Phone: (253) 852-0202
Fax: (253) 852-5361
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DE9342 (WA)

Record details

NPI number1154878668
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacy Nelson — Owner · (253) 852-0206
NPI enumeratedSeptember 1, 2016
Last updated in NPPESMay 11, 2026
Certification dateMay 11, 2026
Mailing address14300 Se Petrovitsky Rd, Renton, WA 98058-8955

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