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NPI Code Detail

MEDICARE: DR. ANDREW W JACOBSON M.D.

MEDICARE: DR. ANDREW W JACOBSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA90312CA

General Provider Information

NPI Number : 1154329407
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW W JACOBSON M.D.
Provider Business Mailing Address
First Line : 9800 4TH AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2152
Country : US
Telephone Number : 206-302-1200
Fax Number :
Provider Business Practice Location Address
First Line : 9800 4TH AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2152
Country : US
Telephone Number : 206-302-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 12/22/2023

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