Provider Demographics
NPI:1417645201
Name:JONES, JUSTINE NICOLE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:NICOLE
Last Name:JONES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18209 E 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-7733
Mailing Address - Country:US
Mailing Address - Phone:206-351-9235
Mailing Address - Fax:
Practice Address - Street 1:18209 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99016-7733
Practice Address - Country:US
Practice Address - Phone:206-351-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61437042363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health