Provider Demographics
NPI:1285719849
Name:JONES, LAURIE L (MFT)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 AMES RD
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-9486
Mailing Address - Country:US
Mailing Address - Phone:509-969-4245
Mailing Address - Fax:509-966-5731
Practice Address - Street 1:132 AMES RD
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-9486
Practice Address - Country:US
Practice Address - Phone:509-969-4245
Practice Address - Fax:509-966-5731
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002390106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA911956677Medicare UPIN