Provider Demographics
NPI:1225507890
Name:JONES, TARA
Entity Type:Organization
Organization Name:JONES, TARA
Other - Org Name:COLUMBIA FAMILY MEDICINE CLINIC L.L.C
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-779-8698
Mailing Address - Street 1:3606 MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2235
Mailing Address - Country:US
Mailing Address - Phone:607-779-8698
Mailing Address - Fax:
Practice Address - Street 1:3606 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2257
Practice Address - Country:US
Practice Address - Phone:607-779-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center