Provider Demographics
NPI:1215617949
Name:ZIEMBA, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:ZIEMBA
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 1:3330 SE DIVISION ST APT 306
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1180
Mailing Address - Country:US
Mailing Address - Phone:216-258-1951
Mailing Address - Fax:
Practice Address - Street 1:12655 SW CENTER ST STE 221
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4769
Practice Address - Country:US
Practice Address - Phone:971-246-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health