Provider Demographics
NPI:1083799407
Name:JONES, DENNIS ALFRED (MA)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:ALFRED
Last Name:JONES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-3209
Mailing Address - Country:US
Mailing Address - Phone:360-419-3606
Mailing Address - Fax:360-419-3610
Practice Address - Street 1:1220 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3209
Practice Address - Country:US
Practice Address - Phone:360-419-3606
Practice Address - Fax:360-419-3610
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00012339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health