Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD00031448 | WA |
NPI | 1043321094 |
---|---|
Provider Name | Andrew D Jacobs |
First Address | Seattle, WA 98101-2756 |
Second Address | Seattle, WA 98101-2756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 26/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039582 | LABOR & INDUSTRY (01) | WA |
804187200 | IDAHO MEDICAID (01) | WA |
8153769 | (05) | WA |
830005116 | RAILROAD MEDICARE (01) | |
E90348 | (02) | |
JA5907 | BLUE SHIELD (01) | WA |
MD843WA | ALASKA MEDICAID (01) | WA |
US0818750 | AETNA/USHC PCP (01) | WA |
US0899710 | AETNA/USHC SPECIALIST (01) | WA |