Provider Demographics
NPI:1598903932
Name:EASTMAN, JAMIE MARIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:EASTMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MARIE
Other - Last Name:TESKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7515 FALCON CREST DR # 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-5014
Mailing Address - Country:US
Mailing Address - Phone:541-904-5216
Mailing Address - Fax:
Practice Address - Street 1:2555 SILVERTON RD NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0837
Practice Address - Country:US
Practice Address - Phone:503-953-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
ORC3457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor