NPI 1134802085

Ive Grace Jacobsen

Practitioner Community Health Worker Pendleton, OR

Practice location

Address: 200 SE Hailey Ave STE 307, Pendleton, OR 97801-3072
Phone: (541) 663-4104
Fax: (541) 429-8822
Mailing address: PO Box 882, Pendleton, OR 97801-0882

Registered specialties

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X Licence THW000109264 (OR)

Other Community Health Worker providers in Oregon →

Registry record

NPI: 1134802085
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Aug 2023
Record last updated: 8 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.