Provider Demographics
NPI:1053813758
Name:MYERS, JAMIE (CADC I, CRM, PSS)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:CADC I, CRM, PSS
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:BARTOSZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 NW GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2078
Mailing Address - Country:US
Mailing Address - Phone:541-383-4293
Mailing Address - Fax:
Practice Address - Street 1:908 NE 4TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4646
Practice Address - Country:US
Practice Address - Phone:541-617-7365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17-CRM-235175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist