Individual
BAILEY COLLEEN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3485 S BOND AVE BLDG 29TH, PORTLAND, OR 97239-4503
(503) 494-5947
Mailing address
4417 EVANSTON AVE N APT 103, SEATTLE, WA 98103-7241
(720) 878-5822
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
WA
106S00000X
Behavior Technician
—
WA
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041449
—
WA
Enumeration date
07/12/2021
Last updated
07/25/2024
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