Organization
SULIS MIND AND BODY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE MAYO (PMHNP)
(830) 370-3765
Entity
Organization
Contact information
Practice address
180 S EMPIRE BLVD, COOS BAY, OR 97420-3352
(541) 203-0154
Mailing address
2670 BROADWAY AVE # B115, NORTH BEND, OR 97459-2214
(541) 203-0154
(541) 982-7030
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
09/07/2023
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