Provider Demographics
NPI:1275705766
Name:JONES, DONALD DALE JR
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:DALE
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 103RD PL NE
Mailing Address - Street 2:M-1
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3647
Mailing Address - Country:US
Mailing Address - Phone:425-454-7688
Mailing Address - Fax:
Practice Address - Street 1:227 BELLEVUE WAY NE
Practice Address - Street 2:#70
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5721
Practice Address - Country:US
Practice Address - Phone:425-454-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator