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1851416028

NPI Code Detail

MEDICARE: JENNIFER MARA JACOB MD

MEDICARE: JENNIFER MARA JACOB MD

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
1	208000000X	Pediatrics Physician	A95584	CA
2	208000000X	Pediatrics Physician	MD60147265	WA
3	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	MD60147265	WA

General Provider Information

NPI Number	:	1851416028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARA JACOB MD

Provider Business Mailing Address
First Line	:	7600 EVERGREEN WAY
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98203-6421
Country	:	US
Telephone Number	:	206-860-5414
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 7TH AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-1132
Country	:	US
Telephone Number	:	206-292-2249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	05/13/2026

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Directions to “ JENNIFER MARA JACOB MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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