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Organization

DIANA JACOBS PHD. LICENSED PSYCHOLOGIST PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA JACOBS PHD (OWNER)
(360) 734-7310
Entity
Organization

Contact information

Practice address
960 HARRIS AVE STE 205, BELLINGHAM, WA 98225-7025
(360) 734-7310
(360) 647-8336
Mailing address
12 BELLWETHER WAY STE 220, BELLINGHAM, WA 98225-2914
(360) 734-7310
(360) 647-8336

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00002516
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1790883353
NPI
WA
Enumeration date
03/22/2017
Last updated
06/03/2019
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