Provider Demographics
NPI:1841274412
Name:JACOBY, KARNY (MD)
Entity type:Individual
Prefix:
First Name:KARNY
Middle Name:
Last Name:JACOBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6005 244TH ST SW
Mailing Address - Street 2:STE 111
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043
Mailing Address - Country:US
Mailing Address - Phone:425-275-5555
Mailing Address - Fax:425-275-5590
Practice Address - Street 1:6005 244TH ST SW
Practice Address - Street 2:STE 111
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043
Practice Address - Country:US
Practice Address - Phone:425-275-5555
Practice Address - Fax:425-275-5590
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2017-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA29412207VF0040X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery