Individual
ALICIA KATHERINE JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1612 NE 78TH ST, VANCOUVER, WA 98665
(360) 573-3223
(360) 573-3224
Mailing address
1612 NE 78TH ST, VANCOUVER, WA 98665
(360) 573-3223
(360) 573-3224
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA00016071
WA
225700000X
Massage Therapist
Primary
MA00016071
WA
Other
Enumeration date
05/05/2006
Last updated
03/22/2011
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