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DR. SAMANTHA VICTORIA JACOBSON PHD
NPI 1477389351
Student in an Organized Health Care Education/Training Program in Seattle, WA

Active since September 09, 2024Opted out of Medicare · through Jan 29, 2027
1200 5TH AVE STE 800, SEATTLE, WA 98101(206) 374-0109(206) 374-0108 Get Directions Write a Review

NPPES record last updated: September 9, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Samantha Victoria Jacobson Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMANTHA VICTORIA JACOBSON PHD (NPI 1477389351) is an individual student in an organized health care education/training program in Seattle, Washington and active in the NPI registry since September 2024. She has opted out of Medicare through January 29, 2027.

NPPES Registry Identity

NPI1477389351
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. SAMANTHA VICTORIA JACOBSONCredential: PHD
Location Address1200 5TH AVE STE 800Seattle, WA 98101-3136
Mailing Address1200 5th Ave Ste 800Seattle, WA 98101-3136 · (206) 374-0109 · Fax (206) 374-0108
Phone(206) 374-0109
Fax(206) 374-0108
Sole ProprietorNo
Enumeration DateSeptember 9, 2024
NPPES CertifiedSeptember 9, 2024
✔ NPI 1477389351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1200 5TH AVE STE 800, Seattle, WA 98101
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Samantha Victoria Jacobson Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 29, 2025 through January 29, 2027.

Opt-Out Effective DateJanuary 29, 2025
Opt-Out In Effect ThroughJanuary 29, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ASHLEIGH MARIE HARVEY PHD
Student in an Organized Health Care Education/Training Program
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
SALLONI NANDA
Student in an Organized Health Care Education/Training Program
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
GHINA HAIDAR PHD
Student in an Organized Health Care Education/Training Program
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
IOP AT DBTCS PLLC
Psychologist
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
KATHERINE HURLEY MANGEN PHD
Psychologist (Clinical)
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
ERIKA RUBERRY
Psychologist (Clinical Child & Adolescent)
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
EMILY BOND
Student in an Organized Health Care Education/Training Program
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (206) 374-0109
COURTNEY CHRISTIAN SIMPSON M.S.
Psychologist
1200 5TH AVE STE 800
SEATTLE, WA 98101
King County (509) 939-4422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Jacobson's NPI number?

The NPI number for Samantha Jacobson is 1477389351. It was assigned to this individual provider in the NPPES registry on September 9, 2024.

Where is Samantha Jacobson located?

Samantha Jacobson practices at 1200 5th Ave Ste 800, Seattle, WA 98101. The listed phone number is (206) 374-0109.

What is Samantha Jacobson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samantha Jacobson enrolled in Medicare?

No. Samantha Jacobson has opted out of Medicare through January 29, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Samantha Jacobson was last updated on September 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.