Organization
JACOBS MENTAL HEALTH SERVICES
Active
Other names
Skycloud Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MADELINE JACOBS PMHNP (OWNER)
(503) 694-3381
Entity
Organization
Contact information
Practice address
13568 SE 97TH AVE STE 202, CLACKAMAS, OR 97015-6668
(503) 694-3381
Mailing address
PO BOX 23993, TIGARD, OR 97281-3993
(612) 210-6965
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407573850
GROUP NPI
—
01
—
1447622477
NPI 1
—
Enumeration date
10/26/2022
Last updated
09/17/2024
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