Provider Demographics
NPI:1144423716
Name:JONES, BETTY KATHERINE (LMP)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:KATHERINE
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 1:4307 FACTORIA BLVD SE STE 1
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1936
Mailing Address - Country:US
Mailing Address - Phone:425-747-5657
Mailing Address - Fax:425-747-5334
Practice Address - Street 1:4307 FACTORIA BLVD SE STE 1
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1936
Practice Address - Country:US
Practice Address - Phone:425-747-5657
Practice Address - Fax:425-747-5334
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA0005895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist