Provider Demographics
NPI:1255507315
Name:GERITY, JAMIE EILEEN (AAS, LMP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:EILEEN
Last Name:GERITY
Suffix:
Gender:F
Credentials:AAS, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7943 E GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-6819
Mailing Address - Country:US
Mailing Address - Phone:360-393-9375
Mailing Address - Fax:
Practice Address - Street 1:7943 E GOLF COURSE DR
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-6819
Practice Address - Country:US
Practice Address - Phone:360-393-9375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60002503174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist