Provider Demographics
NPI:1083344477
Name:PERRY, JAMIE LISA (PSS, CRM)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LISA
Last Name:PERRY
Suffix:
Gender:F
Credentials:PSS, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720-1710
Mailing Address - Country:US
Mailing Address - Phone:541-413-0968
Mailing Address - Fax:541-573-8778
Practice Address - Street 1:348 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720-1710
Practice Address - Country:US
Practice Address - Phone:541-573-8376
Practice Address - Fax:541-573-8378
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist