Provider Demographics
NPI:1518187103
Name:JONES, PENNY CHRISTINE (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:PENNY
Middle Name:CHRISTINE
Last Name:JONES
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHIROPRACTOR
Mailing Address - Street 1:819 SE MORRISON ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-6307
Mailing Address - Country:US
Mailing Address - Phone:503-234-6631
Mailing Address - Fax:503-234-9955
Practice Address - Street 1:819 SE MORRISON ST
Practice Address - Street 2:SUITE 245
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6307
Practice Address - Country:US
Practice Address - Phone:503-234-6631
Practice Address - Fax:503-234-9955
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor