Provider Demographics
NPI:1851262372
Name:JAIME, JOSE MANUEL
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:JAIME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98685
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98496-8685
Mailing Address - Country:US
Mailing Address - Phone:209-445-0200
Mailing Address - Fax:
Practice Address - Street 1:4721 72ND AVENUE CT W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4236
Practice Address - Country:US
Practice Address - Phone:209-445-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter