Provider Demographics
NPI:1659692747
Name:JONES, MONIQUE MIGNON (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:MIGNON
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2055 NW SAVIER ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1770
Mailing Address - Country:US
Mailing Address - Phone:503-494-8417
Mailing Address - Fax:503-494-4455
Practice Address - Street 1:621 SW ALDER ST
Practice Address - Street 2:SUITE 520
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3626
Practice Address - Country:US
Practice Address - Phone:503-494-8417
Practice Address - Fax:503-494-4455
Is Sole Proprietor?:No
Enumeration Date:2010-06-13
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD1673072084P0800X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program