Provider Demographics
NPI:1558489278
Name:JONG, RODNEY ARTHUR SR (MS)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:ARTHUR
Last Name:JONG
Suffix:SR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2978
Mailing Address - Country:US
Mailing Address - Phone:206-499-9325
Mailing Address - Fax:425-637-1289
Practice Address - Street 1:1160 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2978
Practice Address - Country:US
Practice Address - Phone:206-499-9325
Practice Address - Fax:425-637-1289
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist