Provider Demographics
NPI:1477185601
Name:JONES, VALERIE BLAIR (MA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:BLAIR
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7007 BURDEN BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9185
Mailing Address - Country:US
Mailing Address - Phone:509-543-1123
Mailing Address - Fax:
Practice Address - Street 1:7007 BURDEN BLVD STE 104
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-9185
Practice Address - Country:US
Practice Address - Phone:509-543-1123
Practice Address - Fax:509-543-6851
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61031430225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist