Individual
CHRISTOPHER J IACOBELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 SE BISHOP BLVD STE 200, PULLMAN, WA 99163-5537
(509) 332-2517
(509) 334-9247
Mailing address
66 N 6TH ST, POMEROY, WA 99347-9705
(509) 843-1591
(509) 843-1234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301074411
MI
207Q00000X
Family Medicine Physician
M-12956
ID
207Q00000X
Family Medicine Physician
Primary
MD60568380
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0802506201
BCBSM INDIVIDUAL PIN
MI
05
—
2047166
—
WA
05
—
4775269
—
MI
Enumeration date
07/12/2006
Last updated
07/10/2025
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