Provider Demographics
NPI:1356448013
Name:JONES, JAMES M (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 BETHEL RD SE STE 6A
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5600
Mailing Address - Country:US
Mailing Address - Phone:360-895-1010
Mailing Address - Fax:360-895-1017
Practice Address - Street 1:3311 BETHEL RD SE STE 6A
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5600
Practice Address - Country:US
Practice Address - Phone:360-895-1010
Practice Address - Fax:360-895-1017
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA62873OtherLABOR AND INDUSTRIES
WA2012524Medicaid