Provider Demographics
NPI:1902220361
Name:JONES, SANDRA S (LMFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:S
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17926 SE 41ST LOOP
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8277
Mailing Address - Country:US
Mailing Address - Phone:360-606-0107
Mailing Address - Fax:360-326-3826
Practice Address - Street 1:108 SE 124TH STE 10
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6015
Practice Address - Country:US
Practice Address - Phone:360-606-0107
Practice Address - Fax:360-326-3826
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60432544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20150825919054Medicaid