Healthcare Provider Details

I. General information

NPI: 1255966560
Provider Name (Legal Business Name): JAMIE ANN SESSUMS PHT, CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E COZZA DR APT 81
SPOKANE WA
99208-6656
US

IV. Provider business mailing address

1015 E COZZA DR APT 81
SPOKANE WA
99208-6656
US

V. Phone/Fax

Practice location:
  • Phone: 832-889-1951
  • Fax:
Mailing address:
  • Phone: 832-889-1951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberRPT86423
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: