Provider Demographics
NPI:1982231080
Name:JONES, ROSEVELLE
Entity Type:Individual
Prefix:
First Name:ROSEVELLE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 E ROYAL VIEW LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8220
Mailing Address - Country:US
Mailing Address - Phone:360-895-3036
Mailing Address - Fax:
Practice Address - Street 1:6400 E ROYAL VIEW LN
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-8220
Practice Address - Country:US
Practice Address - Phone:360-895-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider