Provider Demographics
NPI:1114100641
Name:JONES, RICHARD CRAIG (BC-HIS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CRAIG
Last Name:JONES
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N 1ST ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-1843
Mailing Address - Country:US
Mailing Address - Phone:541-567-4063
Mailing Address - Fax:
Practice Address - Street 1:405 N 1ST ST STE 107
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1843
Practice Address - Country:US
Practice Address - Phone:541-567-4063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-278859237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR268797OtherOREGON WELFARE