Provider Demographics
NPI:1568936318
Name:JONES, GREGORY D (DNP, PMHNP-BC, CPC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:JONES
Suffix:
Gender:
Credentials:DNP, PMHNP-BC, CPC
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 110804
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98411-0804
Mailing Address - Country:US
Mailing Address - Phone:360-539-8899
Mailing Address - Fax:360-539-1744
Practice Address - Street 1:15413 1ST AVENUE CT S STE 1A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4631
Practice Address - Country:US
Practice Address - Phone:360-539-8899
Practice Address - Fax:360-539-1744
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60784261163W00000X
WAAP61637104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty