Provider Demographics
NPI:1720338783
Name:ROUNDTREE, JAMIE PAULINE (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:PAULINE
Last Name:ROUNDTREE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:PAULINE
Other - Last Name:BARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1265 SW PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3624
Mailing Address - Country:US
Mailing Address - Phone:360-807-7245
Mailing Address - Fax:
Practice Address - Street 1:1265 SW PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3624
Practice Address - Country:US
Practice Address - Phone:360-807-7245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00158716163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool