Provider Demographics
NPI:1194200667
Name:MEYER, JAMIE LEA (ARNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEA
Last Name:MEYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 LIND AVE SW
Mailing Address - Street 2:SUITE 100 ATTN CREDENTIALING
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4970
Mailing Address - Country:US
Mailing Address - Phone:425-690-2715
Mailing Address - Fax:
Practice Address - Street 1:4011 TALBOT RD S STE 500
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5782
Practice Address - Country:US
Practice Address - Phone:425-690-3482
Practice Address - Fax:425-690-9082
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60977515363LF0000X
TXAP137924363LF0000X
CA95010470363LF0000X
WAAP60990851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily