Individual
TIMOTHY DANIEL JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
888 SWIFT BLVD, RICHLAND, WA 99352-3514
(509) 946-4611
Mailing address
550 GAGE BLVD STE 101, RICHLAND, WA 99352-9532
(509) 942-3627
(509) 627-2983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61470203
WA
363A00000X
Physician Assistant
—
WA
Other
Enumeration date
08/28/2023
Last updated
09/07/2023
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