Provider Demographics
NPI:1538365762
Name:HARTLEY, JAMIE MICHELLE (PTA)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MICHELLE
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E PINE NEEDLE AVE
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9226
Mailing Address - Country:US
Mailing Address - Phone:509-468-5146
Mailing Address - Fax:
Practice Address - Street 1:6021 N LIDGERWOOD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1125
Practice Address - Country:US
Practice Address - Phone:509-489-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant