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General NPI Number Information
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NPI Number | 1104577204
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Entity Type | Individual
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Provider Name | JAMIE RAFFETY
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Gender | Female
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 3995 MARCOLA RD
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City | SPRINGFIELD
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State | OR
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Zip | 97477-7948
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Country | US
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Telephone | 541-726-1465
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Fax | 541-726-5085
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Provider Business Mailing Address
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Address Line | 4185 SW RESEARCH WAY STE 110
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City | CORVALLIS
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State | OR
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Zip | 97333-1783
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Country | US
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Telephone | 541-257-5500
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Fax | 541-726-5085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A16285
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License Number State | OR
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