Provider Demographics
NPI:1225518624
Name:THOMAS, JAMIE MYSHELLE (RRT)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:MYSHELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2890 E ARTESIA BLVD APT 13
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2741
Mailing Address - Country:US
Mailing Address - Phone:661-304-7425
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE BLVD S
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6862
Practice Address - Country:US
Practice Address - Phone:914-294-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120700227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty