Individual
JESSAMY HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
265 WESTERN AVE STE 2, SOUTH PORTLAND, ME 04106-2458
(207) 661-0200
(207) 661-0299
Mailing address
265 WESTERN AVE STE 2, SOUTH PORTLAND, ME 04106-2458
(207) 661-0200
(207) 661-0299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2528
ME
Other
Enumeration date
07/18/2022
Last updated
05/12/2025
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