Provider Demographics
NPI:1417959578
Name:MAI, JAYMIE AN (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:JAYMIE
Middle Name:AN
Last Name:MAI
Suffix:
Gender:F
Credentials:PHARMD
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 44321
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98504-4321
Mailing Address - Country:US
Mailing Address - Phone:360-902-6792
Mailing Address - Fax:360-902-6315
Practice Address - Street 1:7273 LINDERSON WAY SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98504-0001
Practice Address - Country:US
Practice Address - Phone:360-902-6792
Practice Address - Fax:360-902-6315
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00018242183500000X
ORRPH0009059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist