Provider Demographics
NPI:1700646338
Name:APODACA, JAMIE LEE (LAC)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:LEE
Last Name:APODACA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:17290 SW SEIFFERT RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8651
Mailing Address - Country:US
Mailing Address - Phone:719-493-8296
Mailing Address - Fax:
Practice Address - Street 1:11203 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-7787
Practice Address - Country:US
Practice Address - Phone:503-698-5500
Practice Address - Fax:503-698-5501
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC218714171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist