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

Nicole Domaschuk-Jackson, PT, DPT

Individual provider Physical Therapist · NPI 1346514718

Nicole Domaschuk-Jackson, PT, DPT is a Physical Therapist in Private Practice in Wasilla, Alaska. Qualified in 2015, 11 years ago. Practices with Southcentral Foundation, a 170-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
11
Licensed in
AK
In the registry since
2012
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone: (907) 729-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 115416 (AK)

Record details

NPI number1346514718
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedMarch 2, 2012
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southcentral Foundation — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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