Individual
LOUIS JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17700 SE 272ND ST, COVINGTON, WA 98042-4951
(253) 372-7000
Mailing address
17700 SE 272ND ST, COVINGTON, WA 98042-4951
(253) 372-7000
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
MD00020499
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0227972
WA DEPT OF LABOR
WA
01
—
12040A
REGIANCE BLUE SHIELD
WA
Enumeration date
09/29/2006
Last updated
03/03/2014
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