Provider Demographics
NPI:1427197730
Name:JONES, KENNETH EARLE (MSPA CCCA)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:EARLE
Last Name:JONES
Suffix:
Gender:M
Credentials:MSPA CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406
Mailing Address - Country:US
Mailing Address - Phone:253-756-6965
Mailing Address - Fax:
Practice Address - Street 1:33515 10 PL S
Practice Address - Street 2:13 CC MANNING AND ASSOCIATES
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7300
Practice Address - Country:US
Practice Address - Phone:253-874-2599
Practice Address - Fax:253-874-2392
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001392237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8337941Medicaid
AB11387Medicare UPIN