Provider Demographics
NPI:1396018313
Name:JONES, ANTHONY LEE (BS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S.W. EMIGRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801
Mailing Address - Country:US
Mailing Address - Phone:541-276-2909
Mailing Address - Fax:541-276-2101
Practice Address - Street 1:901 SW EMIGRANT AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-1948
Practice Address - Country:US
Practice Address - Phone:541-276-7909
Practice Address - Fax:541-276-2101
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0007806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist