Provider Demographics
NPI:1063519494
Name:JONES, ANDREW W (MED MHP)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:W
Last Name:JONES
Suffix:
Gender:M
Credentials:MED MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-0073
Mailing Address - Country:US
Mailing Address - Phone:360-595-2324
Mailing Address - Fax:
Practice Address - Street 1:1220 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3209
Practice Address - Country:US
Practice Address - Phone:360-419-3611
Practice Address - Fax:360-419-3605
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00014456101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor