Individual
SUSAN DIANE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1860 COBURG RD, EUGENE, OR 97401-4945
(541) 465-3966
(541) 465-3967
Mailing address
363 HIGH ST, EUGENE, OR 97401-2309
(541) 465-3966
(541) 465-3967
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
080011725LPN
OR
Other
Enumeration date
07/02/2010
Last updated
07/02/2010
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