Provider Demographics
NPI:1164565123
Name:SMITH, JAMYE (BA)
Entity Type:Individual
Prefix:
First Name:JAMYE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:BA
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 294
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97453-0294
Mailing Address - Country:US
Mailing Address - Phone:541-268-1983
Mailing Address - Fax:
Practice Address - Street 1:1445 WEST 8TH
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439
Practice Address - Country:US
Practice Address - Phone:541-997-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health