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Individual

DR. BENJAMIN J JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 NE MOTHER JOSEPH PL STE 110, VANCOUVER, WA 98664-3293
(360) 254-6161
Mailing address
200 NE MOTHER JOSEPH PL, SUITE 210, VANCOUVER, WA 98664-3299
(360) 254-6161

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD150683
OR
207X00000X
Orthopaedic Surgery Physician
MD60125316
WA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
M150683
OR
207XS0106X
Orthopaedic Hand Surgery Physician
MD60125316
WA

Other

Enumeration date
08/12/2008
Last updated
08/12/2020
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