Provider Demographics
NPI:1073821237
Name:JONES, SHAWNA KRISTINE (LMP)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:KRISTINE
Last Name:JONES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 W 1ST AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-6001
Mailing Address - Country:US
Mailing Address - Phone:509-747-9999
Mailing Address - Fax:509-747-4444
Practice Address - Street 1:417 W 1ST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-6001
Practice Address - Country:US
Practice Address - Phone:509-747-9999
Practice Address - Fax:509-747-4444
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60168603225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist