Provider Demographics
NPI:1962608729
Name:EASTMAN JONES, KATHERINE JOHANNA (LMP, NCTMB)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:JOHANNA
Last Name:EASTMAN JONES
Suffix:
Gender:F
Credentials:LMP, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4155
Mailing Address - Country:US
Mailing Address - Phone:509-670-0979
Mailing Address - Fax:
Practice Address - Street 1:1601 N AURORA AVE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4155
Practice Address - Country:US
Practice Address - Phone:509-670-0979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023655172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist