Provider Demographics
NPI:1184008633
Name:SAWASKY, JAIMIE ALEXANDRA (MS PA-C)
Entity Type:Individual
Prefix:MS
First Name:JAIMIE
Middle Name:ALEXANDRA
Last Name:SAWASKY
Suffix:
Gender:F
Credentials:MS PA-C
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Mailing Address - Street 1:42621 GARFIELD RD.
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CHARTER TOWNSHIP OF CLINTON
Mailing Address - State:MI
Mailing Address - Zip Code:48038
Mailing Address - Country:US
Mailing Address - Phone:586-263-3312
Mailing Address - Fax:586-263-5311
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-2181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601007410363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant