Provider Demographics
NPI:1598216129
Name:JONES, MARLENE D (RN)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2222
Mailing Address - Country:US
Mailing Address - Phone:360-747-7716
Mailing Address - Fax:
Practice Address - Street 1:5612 OCEAN BEACH HWY
Practice Address - Street 2:SUITE 112
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-6214
Practice Address - Country:US
Practice Address - Phone:360-747-7716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00125749163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse