Provider Demographics
NPI:1326241456
Name:FILLEY, JAMIE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:FILLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6348 SW SEYMOUR ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-1142
Mailing Address - Country:US
Mailing Address - Phone:503-215-1655
Mailing Address - Fax:503-215-6485
Practice Address - Street 1:5050 NE HOYT ST STE 156
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2956
Practice Address - Country:US
Practice Address - Phone:503-215-6488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist