Individual
BARRY LEWIS JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4801
Mailing address
497 NEIL BAY DR, FRIDAY HARBOR, WA 98250-9157
(360) 378-1983
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
OR 582
OR
103TC0700X
Clinical Psychologist
Primary
WA PY00003474
WA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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