Provider Demographics
NPI:1568522068
Name:JONES, EILEEN M (PT)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1762
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98071-1762
Mailing Address - Country:US
Mailing Address - Phone:253-931-1341
Mailing Address - Fax:253-288-0816
Practice Address - Street 1:9503 19TH AVE E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-5557
Practice Address - Country:US
Practice Address - Phone:253-471-2727
Practice Address - Fax:253-471-2730
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000033452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8360653Medicaid