Individual
KANUKAYI JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11818 SE MILL PLAIN BLVD, 213, VANCOUVER, WA 98684-5089
(360) 836-4386
Mailing address
303 NE 16TH AVE, APT 106, PORTLAND, OR 97232-3088
(503) 310-8581
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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