Provider Demographics
NPI:1114658374
Name:JONES, JAIME MICHELLE (LSWAIC)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:MICHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 HARRIS AVE STE 201D
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7080
Mailing Address - Country:US
Mailing Address - Phone:360-734-0615
Mailing Address - Fax:
Practice Address - Street 1:4545 CORDATA PKWY STE 1E
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7264
Practice Address - Country:US
Practice Address - Phone:360-752-5246
Practice Address - Fax:360-752-5678
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614929831041C0700X
WA611618111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61161811OtherSOCIAL WORKER ASSOCIATE INDEPENDENT CLINICAL LICENSE