Provider Demographics
NPI:1215058573
Name:WILLIAMS, JAIME NICOLE (BED)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370-9793
Mailing Address - Country:US
Mailing Address - Phone:541-929-3822
Mailing Address - Fax:
Practice Address - Street 1:425 2ND AVE SW STE 201
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2260
Practice Address - Country:US
Practice Address - Phone:541-967-3866
Practice Address - Fax:541-812-5718
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator