Provider Demographics
NPI:1083264832
Name:JONES, MICHAEL JAMAAL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMAAL
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 FAWCETT AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-6124
Mailing Address - Country:US
Mailing Address - Phone:406-698-2345
Mailing Address - Fax:
Practice Address - Street 1:827 CENTRAL AVE N STE B-109
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-3095
Practice Address - Country:US
Practice Address - Phone:253-277-2726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker