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Individual

TIMOTHY W JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1100 9TH AVE, VIRGINIA MASON CTR., PATHOLOGY, SEATTLE, WA 98101-2756
(203) 223-6861
(206) 515-5886
Mailing address
1100 9TH AVE, MS M4-PA, SEATTLE, WA 98101-2756
(206) 583-6025
(206) 515-5886

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
153021
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6985JA
BLUE SHIELD #
WA
05
8317422
WA
05
MD4450W
AK
01
US2871667
AETNA SPECIALIST PIN
WA
Enumeration date
06/01/2006
Last updated
05/15/2008
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