Provider Demographics
NPI:1285767079
Name:READ, JAMIE N (MD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:N
Last Name:READ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 NE ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1616
Mailing Address - Country:US
Mailing Address - Phone:503-281-4046
Mailing Address - Fax:
Practice Address - Street 1:833 SW 11TH AVE
Practice Address - Street 2:SUITE 628
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2125
Practice Address - Country:US
Practice Address - Phone:503-243-7188
Practice Address - Fax:503-243-2129
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD192312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR075882Medicaid
WA8326993Medicaid
OR075882Medicaid
ORE70647Medicare UPIN
OR00WFBRBCMedicare ID - Type Unspecified
WA8326993Medicaid
ORR114558Medicare PIN