Provider Demographics
NPI:1912350315
Name:JAMISON, LISA (LPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:JAMISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:JAMISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HOSCHLER
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:SHADY COVE
Mailing Address - State:OR
Mailing Address - Zip Code:97539-0752
Mailing Address - Country:US
Mailing Address - Phone:541-727-1664
Mailing Address - Fax:
Practice Address - Street 1:801 OHARE PKWY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4001
Practice Address - Country:US
Practice Address - Phone:541-727-1664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health