Provider Demographics
NPI:1013483775
Name:TREADWELL, JAMESA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:JAMESA
Middle Name:
Last Name:TREADWELL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 BOON RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8400
Mailing Address - Country:US
Mailing Address - Phone:360-929-9714
Mailing Address - Fax:
Practice Address - Street 1:1662 BOON RD
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-8400
Practice Address - Country:US
Practice Address - Phone:360-929-9714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-21
Last Update Date:2018-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00004959124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist