Provider Demographics
NPI:1881106318
Name:COPELAND-JONES, GARRETT G (CPHT)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:G
Last Name:COPELAND-JONES
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:GARRETT
Other - Middle Name:G
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:22325 NE OSMAN RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-9653
Mailing Address - Country:US
Mailing Address - Phone:360-910-1230
Mailing Address - Fax:
Practice Address - Street 1:2801 N GANTENBEIN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1623
Practice Address - Country:US
Practice Address - Phone:503-413-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist