Provider Demographics
NPI:1770142713
Name:JAKUBOWSKI, RACHAEL (LMT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:JAKUBOWSKI
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28122
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-0122
Mailing Address - Country:US
Mailing Address - Phone:419-388-5312
Mailing Address - Fax:614-420-2468
Practice Address - Street 1:296 W 4TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3102
Practice Address - Country:US
Practice Address - Phone:193-885-3124
Practice Address - Fax:614-420-2468
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225700000X
OH33.021263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist