# JACKSON LANE ADULT FAMILY HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083521314
- **Authorized official:** MARTIN NJERI (PROVIDER)
- **Authorized official phone:** (206) 402-8182

## Contact information

- **Practice address:** 5308 JACKSON LN, PASCO, WA 99301-9756
- **Practice address phone:** (206) 402-8182
- **Practice address fax:** (509) 207-7943
- **Mailing address:** 5308 JACKSON LN, PASCO, WA 99301-9756
- **Mailing address phone:** (206) 402-8182
- **Mailing address fax:** (509) 207-7943

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/24/2026
- **Last updated:** 08/24/2026