Provider Demographics
NPI:1841446556
Name:JACOBS, MARCIA E (FNP - BC)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:E
Last Name:JACOBS
Suffix:
Gender:
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ALASKAN WAY S STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2785
Mailing Address - Country:US
Mailing Address - Phone:888-731-8994
Mailing Address - Fax:833-775-1861
Practice Address - Street 1:2 EMBARCADERO CTR LBBY LEVEL
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3823
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006066363L00000X
TN13567363LF0000X
AZAP9819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510839Medicaid
TN4239234OtherBLUE CROSS BLUE SHIELD
TN1841446556OtherNPI
TN4239234OtherBLUE CROSS BLUE SHIELD