Provider Demographics
NPI:1902636863
Name:POWER, JAMIE LAYNE (RDH, OMT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LAYNE
Last Name:POWER
Suffix:
Gender:F
Credentials:RDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4537 OLD HIGHWAY 99 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-8575
Mailing Address - Country:US
Mailing Address - Phone:360-708-8656
Mailing Address - Fax:
Practice Address - Street 1:4537 OLD HIGHWAY 99 NORTH RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-8575
Practice Address - Country:US
Practice Address - Phone:360-708-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH60886417124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist