Individual
KEVIN JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14714 53RD AVE W APT 128, EDMONDS, WA 98026-3842
(425) 346-4990
Mailing address
14714 53RD AVE W APT 128, EDMONDS, WA 98026-3842
(425) 346-4990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
61076817
WA
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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