Provider Demographics
NPI:1992315972
Name:JONES, DEBORAH MARIE (AGPCNP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:AGPCNP
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 1685
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-0572
Mailing Address - Country:US
Mailing Address - Phone:503-816-1615
Mailing Address - Fax:
Practice Address - Street 1:15800 BOONES FERRY RD STE A6
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3426
Practice Address - Country:US
Practice Address - Phone:503-816-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202005783NP-PP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health