Bailey Colleen Jacobson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

3485 S Bond Ave BLDG 29TH
Portland, OR 97239-4503

Phone

(503) 494-5947

NPI assigned

Jul 12, 2021

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Blue Water Behavioral Consulting LLC

  • Community/Behavioral Health Agency
  • Oak Harbor, WA
  • NPI 1811311517

  Behavior Analyst

  NPD

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1982276762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 EVANSTON AVE N APT 103",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037241",
            "telephone_number": "720-878-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 S BOND AVE BLDG 29TH",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394503",
            "telephone_number": "503-494-5947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 SE Pioneer Way Ste 201",
            "address_purpose": "LOCATION",
            "city": "Oak Harbor",
            "state": "WA",
            "postal_code": "982775789",
            "country_code": "US",
            "telephone_number": "360-333-5684",
            "fax_number": "360-230-3272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "BAILEY",
        "middle_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041449",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enthns@ohsu.edu",
            "affiliation": "N",
            "address_1": "3485 S Bond Ave Bldg 29th",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972394503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Jacobsen, PA
• Gary A Jacobsen, MD
• Jake Heath Jacobsen, ATR, LCSW
• Jessica C Jacobsen, LCSW
• Natalie Noel Jacobson-Dunlop, MS, CNM
• Ben E Jacobson, M.D.
• Chloe K Jacobson, MA
• Heidi Jacobson, MA
• Julie A Jacobson, PT
• Karen Jacobson, PA-C

• Speech-Language Pathologist in Portland, OR
• Providers in Portland, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.