Individual
DR. PAMELA S JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1616 CORNWALL AVE STE 205, BELLINGHAM, WA 98225-4642
(360) 676-6177
(360) 671-3574
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY61247572
WA
103TC0700X
Clinical Psychologist
1142
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2025952
—
WA
05
—
500655828
—
OR
Enumeration date
07/20/2006
Last updated
04/20/2023
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