Provider Demographics
NPI:1194149443
Name:GILLIAM, JAYME KRISTINA (MOTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:KRISTINA
Last Name:GILLIAM
Suffix:
Gender:F
Credentials:MOTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 E 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6678
Mailing Address - Country:US
Mailing Address - Phone:509-252-2354
Mailing Address - Fax:
Practice Address - Street 1:2710 E 57TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-6678
Practice Address - Country:US
Practice Address - Phone:509-252-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WATL 60442903225XH1200X
WAOT60444643225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand