Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY00001468 | WA |
Y | 103T00000X | Psychologist | PY00001468 | WA |
NPI | 1013053008 |
---|---|
Provider Name | Dr. Jane Kate Harmon Jacobs |
First Address | Seattle, WA 98136-1562 |
Second Address | Seattle, WA 98136-1562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7112436 | (05) | WA |