Provider Demographics
NPI:1417221060
Name:JONES, JENNIFER M (LMT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 MARY JANE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3634
Mailing Address - Country:US
Mailing Address - Phone:541-261-6021
Mailing Address - Fax:
Practice Address - Street 1:969 MARY JANE AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3634
Practice Address - Country:US
Practice Address - Phone:541-261-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR15463OtherOREGON BOARD OF MASSAGE THERAPISTS