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Individual

MS. JAMIE LANE NIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
403 BLACK HILLS LN SW STE B, OLYMPIA, WA 98502-8600
(360) 709-9500
(360) 754-4517
Mailing address
403 BLACK HILLS LN SW STE B, OLYMPIA, WA 98502-8600
(360) 709-9500
(360) 754-4517

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005075
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8464158
WA
01
P00346592
RAILROAD MEDICARE
Enumeration date
10/02/2006
Last updated
03/07/2023
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