Basic Information
Provider Information | |||||||||
NPI: | 1194069385 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SEAVEY | ||||||||
FirstName: | JAMILEE | ||||||||
MiddleName: | CATHY | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | OTR | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | ADAMS | ||||||||
OtherFirstName: | JAMILEE | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 3100 CHANNEL DR STE 300 | ||||||||
Address2: |   | ||||||||
City: | JUNEAU | ||||||||
State: | AK | ||||||||
PostalCode: | 998017837 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9074634074 | ||||||||
FaxNumber: | 9074631510 | ||||||||
Practice Location | |||||||||
Address1: | 209 MOLLER AVE STE 100 | ||||||||
Address2: |   | ||||||||
City: | SITKA | ||||||||
State: | AK | ||||||||
PostalCode: | 998357142 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9077471771 | ||||||||
FaxNumber: | 9077478853 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/12/2012 | ||||||||
LastUpdateDate: | 07/16/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/16/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 113680 | TX | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |   |
ID Information
ID | Type | State | Issuer | Description | 114425 | 01 | AK | STATE OF ALASKA | OTHER |