Provider Demographics
NPI:1932231172
Name:LONEY, JAYNE R (LMP)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:R
Last Name:LONEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16920 NE 100TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3148
Mailing Address - Country:US
Mailing Address - Phone:425-883-7189
Mailing Address - Fax:425-883-7189
Practice Address - Street 1:16920 NE 100TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3148
Practice Address - Country:US
Practice Address - Phone:425-883-7189
Practice Address - Fax:425-883-7189
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist