Provider Demographics
NPI:1649720657
Name:WEEMS, JAMIE MICHAEL (HAS)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHAEL
Last Name:WEEMS
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 S UNION AVE
Mailing Address - Street 2:102
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1959
Mailing Address - Country:US
Mailing Address - Phone:253-759-3555
Mailing Address - Fax:253-759-2988
Practice Address - Street 1:1833 AUBURN WAY N
Practice Address - Street 2:SUITE M
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-3361
Practice Address - Country:US
Practice Address - Phone:253-759-3555
Practice Address - Fax:253-759-2988
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA60442565237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist