Individual
JANIS ANN JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
22760 MARINE VIEW DR S, DES MOINES, WA 98198-8408
(206) 824-0107
(206) 870-6812
Mailing address
PO BOX 13153, DES MOINES, WA 98198-1003
(206) 824-0107
(206) 870-6812
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00017566
WA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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