Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grant Jacobsen

Individual provider Internal Medicine Physician · NPI 1306647581

Grant Jacobsen is an Internal Medicine Physician in Boise, Idaho. Licensed in Idaho and Washington. Registered with an NPI since 2025.

Licensed in
ID, WA
In the registry since
2025
Specialties on file
2

Practice location Address checks out

500 W Fort St # 111R
Boise, ID 83702-4599
Phone: (208) 422-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular & Interventional Radiology Physician (primary) Taxonomy 2085R0204X · Licence MDRE.ML.70106827 (WA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 7271468 (ID)

Record details

NPI number1306647581
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 22, 2025
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026
Mailing address500 W Fort St # 111r, Boise, ID 83702-4599

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