Organization
JACOBS MH OF WASHINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADELINE JACOBS PMHNP (OWNER)
(503) 694-3381
Entity
Organization
Contact information
Practice address
160 NW GILMAN BLVD, ISSAQUAH, WA 98027-2422
(503) 694-3381
Mailing address
PO BOX 23993, TIGARD, OR 97281-3993
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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