Alicia May Jacobson, LLPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

60837151 Issued in WA

Practice address

1601 E 4TH Plain Blvd BLDG 17
Vancouver, WA 98661-3717

Phone

(360) 397-8246

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Alicia Jacobson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1013553643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W MCLOUGHLIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602314",
            "telephone_number": "360-566-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD BLDG 17",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613717",
            "telephone_number": "360-397-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ALICIA",
        "middle_name": "MAY",
        "credential": "LLPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "60837151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "JACOBSON",
            "credential": "MILLAR FLETTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin J Jacobs, MD
• Helen Marymae Jacobs, CDP
• Elizabeth Marta Jacobsen, LMFT
• Kanukayi Jacobsen
• Paul Jacobsen, M.D.
• Bjorn Allan Jacobson, MD
• Gail H Jacobson, MD
• Jazmin Hope Jacobson I, LMHC
• Katherine Jacobson
• Ryan Paul Jacobson, PT

• Licensed Practical Nurse in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.