Provider Demographics
NPI:1447819495
Name:POLLY H. JAMISON, PH.D.
Entity type:Organization
Organization Name:POLLY H. JAMISON, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/ OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:R
Authorized Official - Last Name:STRONG-HOLTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-343-9697
Mailing Address - Street 1:2150 DALTON DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2201
Mailing Address - Country:US
Mailing Address - Phone:541-343-9697
Mailing Address - Fax:541-688-0068
Practice Address - Street 1:2150 DALTON DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-2201
Practice Address - Country:US
Practice Address - Phone:541-343-9697
Practice Address - Fax:541-688-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty