Provider Demographics
NPI:1588340699
Name:JONES, TOMIKA DEVIN
Entity type:Individual
Prefix:
First Name:TOMIKA
Middle Name:DEVIN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 NE MARTIN LUTHER KING JR BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2086
Mailing Address - Country:US
Mailing Address - Phone:503-860-0303
Mailing Address - Fax:
Practice Address - Street 1:3311 NE MARTIN LUTHER KING JR BLVD STE 104
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2086
Practice Address - Country:US
Practice Address - Phone:503-860-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)