Provider Demographics
NPI:1750159539
Name:JAMISON, RIAN ELIZABETH
Entity type:Individual
Prefix:MISS
First Name:RIAN
Middle Name:ELIZABETH
Last Name:JAMISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 NE 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-3376
Mailing Address - Country:US
Mailing Address - Phone:360-723-3465
Mailing Address - Fax:
Practice Address - Street 1:1218 NE 88TH ST STE 108
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-9696
Practice Address - Country:US
Practice Address - Phone:360-314-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61503293225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist