Provider Demographics
NPI:1427726421
Name:JAMMERMAN, SIERRA RYANNE
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:RYANNE
Last Name:JAMMERMAN
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 1:120 E MOUNTAIN BROOK LN
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-9159
Mailing Address - Country:US
Mailing Address - Phone:425-591-4665
Mailing Address - Fax:
Practice Address - Street 1:6505 218TH ST SW STE 12
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2135
Practice Address - Country:US
Practice Address - Phone:206-565-1286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician