# JACOBSON COMMUNITY MENTAL HEALTH AND WELLNESS PLLC

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

## Provider details

- **NPI number:** 1316776818
- **Authorized official:** HOLLY L. JACOBSON PMHNP (CEO)
- **Authorized official phone:** (818) 913-2075

## Contact information

- **Practice address:** 11900 NE 1ST ST STE 300, BELLEVUE, WA 98005-3049
- **Practice address phone:** (818) 913-2075
- **Mailing address:** 14110 NE 21ST ST APT 1095, BELLEVUE, WA 98007-3719
- **Mailing address phone:** (818) 913-2075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2024
- **Last updated:** 09/26/2024