Provider Demographics
NPI:1891783973
Name:JONES, KENNETH L (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W A ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2605
Mailing Address - Country:US
Mailing Address - Phone:509-453-5556
Mailing Address - Fax:509-453-5557
Practice Address - Street 1:601 W A ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2605
Practice Address - Country:US
Practice Address - Phone:509-453-5556
Practice Address - Fax:509-453-5557
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA15630OtherLABOR & INDUSTRIES
WA2024503Medicaid
T02071Medicare UPIN