Provider Demographics
NPI:1467247247
Name:JARAMILLO, EDWARD
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:JARAMILLO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 SE CITY BEACH ST UNIT 2563
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3019
Mailing Address - Country:US
Mailing Address - Phone:303-434-9918
Mailing Address - Fax:
Practice Address - Street 1:36250 STATE RTE 20
Practice Address - Street 2:SUITE E204
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3019
Practice Address - Country:US
Practice Address - Phone:208-996-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician