Individual
JILL K JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1728 W MARINE VIEW DR, SUITE 106, EVERETT, WA 98201-2094
(425) 339-5453
(425) 252-4441
Mailing address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 259-0966
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60032612
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY60032612
WASHINGTON STATE LICENSE
WA
Enumeration date
09/23/2008
Last updated
09/23/2008
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