Provider Demographics
NPI:1396753257
Name:FREEMAN, JAMIE JANELLE (PAC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:JANELLE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:929 SW SIMPSON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3599
Mailing Address - Country:US
Mailing Address - Phone:541-389-7741
Mailing Address - Fax:541-278-8376
Practice Address - Street 1:929 SW SIMPSON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3599
Practice Address - Country:US
Practice Address - Phone:541-389-7741
Practice Address - Fax:541-278-8376
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2013-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORPA00944363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORQ12286Medicare UPIN