Provider Demographics
NPI:1932287604
Name:JONES, JASON D (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:D
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 1:26832 MAPLE VALLEY BLACK DIAMOND RD SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-8309
Mailing Address - Country:US
Mailing Address - Phone:425-432-9001
Mailing Address - Fax:425-432-0838
Practice Address - Street 1:26832 MAPLE VALLEY BLACK DIAMOND RD SE
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8309
Practice Address - Country:US
Practice Address - Phone:425-432-9001
Practice Address - Fax:425-432-0838
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0146105OtherLABOR AND INDUSTRY
WA0146105OtherLABOR AND INDUSTRY