Provider Demographics
NPI:1801398599
Name:EMERY, JAIMYN MAREE
Entity Type:Individual
Prefix:
First Name:JAIMYN
Middle Name:MAREE
Last Name:EMERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 BAILEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1159
Mailing Address - Country:US
Mailing Address - Phone:541-232-5639
Mailing Address - Fax:
Practice Address - Street 1:2411 MARTIN LUTHER KING JR. BLVD.
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-682-3608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health