Provider Demographics
NPI:1164080198
Name:JONES, CHENELL
Entity Type:Individual
Prefix:
First Name:CHENELL
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8508 NE KNOTT ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-5385
Mailing Address - Country:US
Mailing Address - Phone:503-995-2759
Mailing Address - Fax:
Practice Address - Street 1:8508 NE KNOTT ST UNIT D
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-5385
Practice Address - Country:US
Practice Address - Phone:503-995-2759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR657771Medicaid