Provider Demographics
NPI:1972084812
Name:HUBBARD-PARKER, JAMIE MALYNN (AUD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MALYNN
Last Name:HUBBARD-PARKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MALYNN
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3099 RIVER RD S
Mailing Address - Street 2:STE 150
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9754
Mailing Address - Country:US
Mailing Address - Phone:503-485-2571
Mailing Address - Fax:503-485-2564
Practice Address - Street 1:3099 RIVER RD S # 120
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9754
Practice Address - Country:US
Practice Address - Phone:503-485-2581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30927231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist