Individual
MS. LORI JEAN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1275 HIGHLAND AVE, CLARKSTON, WA 99403-2846
(509) 758-2555
Mailing address
2951 DOVE LN, CLARKSTON, WA 99403-1460
(509) 758-5438
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10319
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4902981
NABP
WA
05
—
6173801
—
WA
Enumeration date
12/13/2006
Last updated
07/08/2007
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