Provider Demographics
NPI:1811785058
Name:JAMIESON, RYAN ANDREW
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ANDREW
Last Name:JAMIESON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:RYAN -OR- JAMIESON
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:22520 MILLENBACH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2593
Mailing Address - Country:US
Mailing Address - Phone:586-871-8556
Mailing Address - Fax:
Practice Address - Street 1:22520 MILLENBACH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2593
Practice Address - Country:US
Practice Address - Phone:586-871-8556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program