Provider Demographics
NPI:1639153620
Name:JONES, JUDITH MARIE HOWARD (LMP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:MARIE HOWARD
Last Name:JONES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6916 132ND PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-9502
Mailing Address - Country:US
Mailing Address - Phone:425-753-5929
Mailing Address - Fax:425-861-8987
Practice Address - Street 1:6916 132ND PL NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-9502
Practice Address - Country:US
Practice Address - Phone:425-753-5929
Practice Address - Fax:425-861-8987
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019306225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist