Provider Demographics
NPI:1093910333
Name:JONES, BONNIE DELIGHT (LMP)
Entity Type:Individual
Prefix:MISS
First Name:BONNIE
Middle Name:DELIGHT
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 1:30 LAKE SHORE PLZ STE B
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6175
Mailing Address - Country:US
Mailing Address - Phone:206-629-8882
Mailing Address - Fax:425-822-4325
Practice Address - Street 1:30 LAKE SHORE PLZ STE B
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6175
Practice Address - Country:US
Practice Address - Phone:206-629-8882
Practice Address - Fax:425-822-4325
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMAOOO8865174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist