Provider Demographics
NPI:1861919052
Name:SIMONS, JAIMEY KRISTIN
Entity type:Individual
Prefix:
First Name:JAIMEY
Middle Name:KRISTIN
Last Name:SIMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 197TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8920
Mailing Address - Country:US
Mailing Address - Phone:530-320-6363
Mailing Address - Fax:
Practice Address - Street 1:949 MARKET ST STE 602
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3693
Practice Address - Country:US
Practice Address - Phone:253-954-3354
Practice Address - Fax:253-954-3354
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60796362363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical