Provider Demographics
NPI:1659034999
Name:WESTERN, JAMIY
Entity Type:Individual
Prefix:
First Name:JAMIY
Middle Name:
Last Name:WESTERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMIY
Other - Middle Name:
Other - Last Name:WESTERN-GRINDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1317 ILLINOIS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-5838
Mailing Address - Country:US
Mailing Address - Phone:989-492-5452
Mailing Address - Fax:
Practice Address - Street 1:1317 ILLINOIS DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-5838
Practice Address - Country:US
Practice Address - Phone:989-492-5452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist