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Individual

ELISABETH DORAN JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
20200 54TH AVE W, LYNNWOOD, WA 98036-6318
(425) 672-6518
(425) 672-6518
Mailing address
20200 54TH AVE W, LYNNWOOD, WA 98036-6318
(425) 672-6518
(425) 672-6518

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A75610
CA
207Q00000X
Family Medicine Physician
Primary
MD60117921
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A756100
CA
Enumeration date
01/04/2007
Last updated
04/19/2021
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