Individual
KATRINA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
1900 NE HIGHWAY 99W STE K, MCMINNVILLE, OR 97128-2757
(503) 714-6306
Mailing address
PO BOX 133, MCMINNVILLE, OR 97128-0133
(503) 714-6306
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
1744R1102X
Research Study Specialist
—
—
174H00000X
Health Educator
—
—
225C00000X
Rehabilitation Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
07/07/2020
Last updated
11/27/2023
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