Active NPI
Jessica Maria Jacobo, PHARMD
- Pharmacist
- Seattle, WA
National Provider Identifier
1164830626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60752144
- Practice address
- 500 17TH Ave
Seattle, WA 98122-5711 - Phone
- (206) 635-4005
- NPI assigned
- Jul 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60752144 | WA | Primary |
Addresses
Primary practice location
500 17TH Ave
Seattle, WA 98122-5711
Mailing address
1626 2ND Ave SW
Quincy, WA 98848-1772
Phone (509) 964-1925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60752144 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729900800000",
"number": "1164830626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 2ND AVE SW",
"city": "QUINCY",
"state": "WA",
"postal_code": "988481772",
"telephone_number": "509-964-1925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 17TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225711",
"telephone_number": "206-635-4005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBO",
"first_name": "JESSICA",
"middle_name": "MARIA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-29",
"last_updated": "2024-10-26",
"certification_date": "2024-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60752144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.