Provider Demographics
NPI:1467769521
Name:JAKUBOWSKI, JULIA
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:JAKUBOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-3519
Mailing Address - Country:US
Mailing Address - Phone:503-217-9303
Mailing Address - Fax:
Practice Address - Street 1:526 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-3519
Practice Address - Country:US
Practice Address - Phone:503-217-9303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR107141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical