Provider Demographics
NPI:1083848626
Name:JONES, KENDRA MARIE (LMP)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MARIE
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 1:1332 164TH ST SW
Mailing Address - Street 2:SUITE 401
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8513
Mailing Address - Country:US
Mailing Address - Phone:425-742-7772
Mailing Address - Fax:425-742-9001
Practice Address - Street 1:1332 164TH ST SW
Practice Address - Street 2:SUITE 401
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-8513
Practice Address - Country:US
Practice Address - Phone:425-742-7772
Practice Address - Fax:425-742-9001
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024648225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist