Provider Demographics
NPI:1689989311
Name:JONES, DOUGLAS MARVIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:MARVIN
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W HASTINGS RD
Mailing Address - Street 2:SUITE A104
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-5012
Mailing Address - Country:US
Mailing Address - Phone:509-481-0550
Mailing Address - Fax:
Practice Address - Street 1:319 W HASTINGS RD
Practice Address - Street 2:SUITE A104
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-5012
Practice Address - Country:US
Practice Address - Phone:509-481-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005902101YM0800X
TX15655101YP2500X
WALF00001818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional