Individual
MRS. LEA RENAE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1015 NE HOSTMARK ST, SUITE 101, POULSBO, WA 98370
(360) 697-7726
(360) 677-7728
Mailing address
9621 RIDGETOP BLVD, SUITE 100, SILVERDALE, WA 98383
(360) 337-7662
(360) 337-7300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00010056
WA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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