Provider Demographics
NPI:1689756165
Name:JONES, DAWN LOUISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:LOUISE
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:LOUISE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3821 WOODLAWN DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5141
Mailing Address - Country:US
Mailing Address - Phone:360-459-2370
Mailing Address - Fax:
Practice Address - Street 1:1830 112TH ST E
Practice Address - Street 2:UNIT D
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-3747
Practice Address - Country:US
Practice Address - Phone:253-548-8400
Practice Address - Fax:253-537-3150
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA188050OtherL&I