MEDICARE: DR. GREGORY D JONES DNP, PMHNP-BC, CPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN60784261	WA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61637104	WA

General Provider Information

NPI Number	:	1568936318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY D JONES DNP, PMHNP-BC, CPC

Provider Business Mailing Address
First Line	:	PO BOX 110804
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98411-0804
Country	:	US
Telephone Number	:	360-539-8899
Fax Number	:	360-539-1744

Provider Business Practice Location Address
First Line	:	15413 1ST AVENUE CT S STE 1A
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98444-4631
Country	:	US
Telephone Number	:	360-539-8899
Fax Number	:	360-539-1744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	03/07/2025

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