Provider Demographics
NPI:1275743346
Name:JONES, CYNTHIA K
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:K
Other - Last Name:MOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:LOON LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99148-0923
Mailing Address - Country:US
Mailing Address - Phone:509-467-8176
Mailing Address - Fax:
Practice Address - Street 1:9419 N NEWPORT HWY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1243
Practice Address - Country:US
Practice Address - Phone:509-467-8176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005607172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist