Provider Demographics
NPI:1841337482
Name:JONES, OLIVIA L (DO)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 NE 139TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2513
Mailing Address - Country:US
Mailing Address - Phone:360-566-9355
Mailing Address - Fax:360-816-1327
Practice Address - Street 1:900 NE 139TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2513
Practice Address - Country:US
Practice Address - Phone:360-566-9355
Practice Address - Fax:360-816-1327
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00001829207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7125131Medicaid
WAH73507Medicare UPIN
WA7125131Medicaid