Provider Demographics
NPI:1225559958
Name:JONES, ANGELIA LATERRA
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:LATERRA
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 1:1901 MARTIN LUTHER KING JR WAY S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-4801
Mailing Address - Country:US
Mailing Address - Phone:206-322-7676
Mailing Address - Fax:206-726-7585
Practice Address - Street 1:1901 MARTIN LUTHER KING JR. WAY S.
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144
Practice Address - Country:US
Practice Address - Phone:206-322-7676
Practice Address - Fax:206-726-7585
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health