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General NPI Number Information
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NPI Number | 1518390913
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Entity Type | Individual
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Provider Name | JESSICA JACOBS
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Gender | Female
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 748 MARKET ST # 32
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City | TACOMA
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State | WA
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Zip | 98402-3737
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Country | US
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Telephone | 502-407-4261
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Fax |
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Provider Business Mailing Address
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Address Line | 748 MARKET ST # 32
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City | TACOMA
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State | WA
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Zip | 98402-3737
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Country | US
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Telephone | 502-407-4261
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6989
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12181-C
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW24384
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW607576111
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License Number State | WA
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