NPIMap

Organization Active NPI

Jacobs MH of Washington

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Issaquah, WA
National Provider Identifier
1033910450
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JACOBS MH OF WASHINGTON
Practice address
160 NW Gilman Blvd
Issaquah, WA 98027-2422
Phone
(503) 694-3381
NPI assigned
Mar 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Madeline Jacobs, PMHNPNPI 1447622477
Title
Owner
Phone
(503) 694-3381

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

160 NW Gilman Blvd
Issaquah, WA 98027-2422

Mailing address

PO Box 23993
Tigard, OR 97281-3993

National Provider Directory

National Provider Directory

Locations

160 NW Gilman Blvd
Issaquah, WA 98027
Phone (425) 505-1995

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1033910450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23993",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972813993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW GILMAN BLVD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272422",
            "telephone_number": "503-694-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOBS MH OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "MADELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-694-3381",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.