Provider Demographics
NPI:1205191186
Name:JACOBS, JOSHUA NATHANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:NATHANIEL
Last Name:JACOBS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:M/S OB.6.402
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-7458
Mailing Address - Fax:206-985-3272
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:M/S OB.6.402
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-7458
Practice Address - Fax:206-985-3272
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-07
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51523183500000X, 183500000X
HIPH-4578183500000X, 183500000X
WAPH60993329183500000X, 183500000X
MO2015003318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist