Provider Demographics
NPI:1780822916
Name:JONES, STEPHANIE RENEE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 SE 131ST AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-4013
Mailing Address - Country:US
Mailing Address - Phone:360-433-9580
Mailing Address - Fax:866-824-5107
Practice Address - Street 1:406 SE 131ST AVE STE 203
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4013
Practice Address - Country:US
Practice Address - Phone:360-433-9580
Practice Address - Fax:866-824-5107
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60010435363LF0000X
WAAP60075691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201150158NPOtherOR NURSE PRACTITIONER LICENSE