Individual
DR. HEIDI L JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16508
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005591010
REGENCE BLUE CROSS
OR
05
—
011895
—
OR
Enumeration date
01/20/2006
Last updated
03/27/2020
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