Individual
DR. SHALINI MARY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MRCP, FACP
Contact information
Practice address
413 LILLY RD NE, PMG SW WA PSPH HOSPITALISTS, OLYMPIA, WA 98506-5133
(360) 493-4069
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036705
WA
208M00000X
Hospitalist Physician
27907
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8245243
—
WA
Enumeration date
12/21/2005
Last updated
06/01/2021
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