Provider Demographics
NPI:1760639587
Name:JOHNSTON, JAYMIE L (MS)
Entity Type:Individual
Prefix:
First Name:JAYMIE
Middle Name:L
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JAYMIE
Other - Middle Name:L
Other - Last Name:CHAMBERLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:1329 LINCOLN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6279
Mailing Address - Country:US
Mailing Address - Phone:360-389-3064
Mailing Address - Fax:360-647-6719
Practice Address - Street 1:1329 LINCOLN ST STE 1
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6279
Practice Address - Country:US
Practice Address - Phone:360-389-3064
Practice Address - Fax:360-647-6719
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 104100000X, 171M00000X
WALH60749504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator