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NPI Code Detail

MEDICARE: KATHLEEN JACOBSON OTR/L, LMT

MEDICARE: KATHLEEN JACOBSON OTR/L, LMT
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
1225X00000XOccupational Therapist60067865WA
2225700000XMassage Therapist00011077WA

General Provider Information

NPI Number : 1508484387
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN JACOBSON OTR/L, LMT
Provider Business Mailing Address
First Line : 4020 NE 57TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98105-2244
Country : US
Telephone Number : 206-295-3088
Fax Number :
Provider Business Practice Location Address
First Line : 2265 N 56TH ST # 2B
Second Line :
City : SEATTLE
State : WA
Zip : 98103-6209
Country : US
Telephone Number : 206-295-3088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2020
Last Update Date : 09/30/2024

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Directions to “ KATHLEEN JACOBSON OTR/L, LMT” Practice Location

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