Justin Jacobs, is a
Psychologist - Clinical based in Clackamas, Oregon. Justin Jacobs is licensed to practice in Oregon (license number R272) and his current practice location is
10151 Se Sunnyside Rd Ste 480, Clackamas, Oregon. He can be reached at his office (for appointments etc.) via phone at
(971) 915-0046.
NPI number for Justin Jacobs is 1801522420 and his current mailing address is 10151 Se Sunnyside Rd Ste 480, Clackamas, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1801522420.
Healthcare Provider's Profile
| Full Name | Justin Jacobs |
|---|
| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 10151 Se Sunnyside Rd Ste 480, Clackamas, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1801522420
- Provider Enumeration Date: 07/26/2022
- Last Update Date: 09/10/2024
Medical Identifiers
Medical identifiers for Justin Jacobs such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801522420 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | R272 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Jacobs is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Justin Jacobs,
10151 Se Sunnyside Rd Ste 480,
Clackamas, OR 97015-5705
Ph: (971) 915-0046 | Justin Jacobs,
10151 Se Sunnyside Rd Ste 480,
Clackamas, OR 97015-5705
Ph: (971) 915-0046 |
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