Individual
DR. KELLIE L. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3500 ORCHARD PL, BELLINGHAM, WA 98225-1749
(360) 671-3900
(360) 647-0882
Mailing address
709 W ORCHARD DR, SUITE 4, BELLINGHAM, WA 98225-1766
(360) 318-8800
(360) 318-1085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00028253
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0130079
LABOR & INDUSTRIES (REG)
WA
01
—
080148055
RAILROAD MEDICARE
WA
01
—
14535
REGENCE BLUESHIELD
WA
01
—
423898022
GROUP HEALTH COOPERATIVE
WA
05
—
8127276
—
WA
01
—
8925030
LABOR & INDUSTRIES (CV)
WA
Enumeration date
05/28/2006
Last updated
07/24/2012
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