Stephanie Lynn Jacobson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

202106433NP-PP Issued in OR

Practice address

5000 N Willamette Blvd
Portland, OR 97203-5798

Phone

(503) 943-8000

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Portland Health Center

  • Student Health Clinic/Center
  • Portland, OR
  • NPI 1356545875
  NPD (past)

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1962056556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 SW CARSON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972194332",
            "telephone_number": "503-351-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 N WILLAMETTE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972035798",
            "telephone_number": "503-943-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200842440RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202106433NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Edward Jacobson, MD
• Melissa Dawn Jacobson, RD, CDE
• Nicole Jacobson, RN
• Rayna Joyce Jacobson, L.AC., R.N.
• Sig-Linda Jacobson, M.D.
• Susan Rae Jacobson
• Timothy Dennis Jacobson, MD
• Toni K Jacobson
• Allison Jacoby-Fries
• Brian Phillip Jacoby I, MA

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.