Provider Demographics
NPI:1154488914
Name:DEAL, JAMI (OTRL)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:DEAL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 PRAIRIE PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3145
Mailing Address - Country:US
Mailing Address - Phone:701-356-0062
Mailing Address - Fax:701-356-5412
Practice Address - Street 1:1207 PRAIRIE PKWY
Practice Address - Street 2:STE. A
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3145
Practice Address - Country:US
Practice Address - Phone:701-356-0062
Practice Address - Fax:701-356-5412
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND51155Medicaid
ND5739896OtherFIRST HEALTH PROVIDER ID
NDDEA27048OtherBCBS ND PROVIDER NUMBER