Individual
KIMBERLY ANN JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-PC
Contact information
Practice address
1425 BEAVERCREEK ROAD, OREGON CITY, OR 97045-4023
(503) 655-8471
(503) 655-8595
Mailing address
613 N BIRCH ST, CANBY, OR 97013-3326
(503) 341-3944
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
202100947NP-PP
OR
Other
Enumeration date
08/30/2012
Last updated
02/24/2021
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