Provider Demographics
NPI:1346449089
Name:JONES, SEDONNI KAYE (LMP)
Entity Type:Individual
Prefix:MS
First Name:SEDONNI
Middle Name:KAYE
Last Name:JONES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21200 E COUNTRY VISTA DR APT I202
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7681
Mailing Address - Country:US
Mailing Address - Phone:509-868-4747
Mailing Address - Fax:
Practice Address - Street 1:21200 E COUNTRY VISTA DR APT I202
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7681
Practice Address - Country:US
Practice Address - Phone:509-868-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013048225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist