Provider Demographics
NPI:1952675761
Name:JONES, CHERYL ANN (OT/L, CHT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:OT/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10328 N RICKEL LN
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-7844
Mailing Address - Country:US
Mailing Address - Phone:509-795-0271
Mailing Address - Fax:509-357-5060
Practice Address - Street 1:5322 N DIVISION ST
Practice Address - Street 2:STE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1300
Practice Address - Country:US
Practice Address - Phone:509-795-0271
Practice Address - Fax:509-357-5060
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001469225X00000X, 225XH1200X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1952675761Medicare Oscar/Certification