Provider Demographics
NPI:1790589729
Name:SIMS, AMETHYST SOLARIS
Entity type:Individual
Prefix:
First Name:AMETHYST
Middle Name:SOLARIS
Last Name:SIMS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:ANNE
Other - Last Name:MCNERNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1424 E 18TH AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-1415
Mailing Address - Country:US
Mailing Address - Phone:571-318-1913
Mailing Address - Fax:
Practice Address - Street 1:2222 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2475
Practice Address - Country:US
Practice Address - Phone:541-224-6987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician