Provider Demographics
NPI:1528519345
Name:SCULLEY, JAMIE (ND)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:SCULLEY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:# 317 1400 W WASHINGTON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382
Mailing Address - Country:US
Mailing Address - Phone:360-207-4325
Mailing Address - Fax:833-275-1789
Practice Address - Street 1:551 PINNELL RD
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-7584
Practice Address - Country:US
Practice Address - Phone:360-207-4325
Practice Address - Fax:833-275-1789
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60695611175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath