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

Individual provider Speech-Language Pathologist · NPI 1942188735

Michael Thomas Jacezko is a Qualified Speech Language Pathologist in Seattle, Washington. Graduated from University of Missouri, Columbia School of Medicine in 2024, 2 years ago. Licensed in Washington.

Years since qualifying
2
Trained at
University of Missouri, Columbia School of Medicine
Licensed in
WA
In the registry since
2025
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Practice location Address checks out

1660 S Columbian Way
Seattle, WA 98108-1532
Phone: (206) 762-1010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 70012996 (WA)

Record details

NPI number1942188735
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 21, 2025
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025
Mailing address430 12th Ave E Apt 207, Seattle, WA 98102-5149

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolUNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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