MEDICARE: AFINNIECO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	170100000X	Ph.D. Medical Genetics
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1669284717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFINNIECO

Provider Business Mailing Address
First Line	:	5301 S ORCHARD ST APT 4
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98467-3679
Country	:	US
Telephone Number	:	405-762-2170
Fax Number	:	405-762-2170

Provider Business Practice Location Address
First Line	:	5301 S ORCHARD ST APT 4
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98467-3679
Country	:	US
Telephone Number	:	405-762-2170
Fax Number	:	405-762-2170

Authorized Official
Title or Position	:	CFO
Name	:	MS. ARDRETTA KENYAE JONES I
Credential	:	DSP CM
Telephone Number	:	405-762-2170

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	05/07/2026

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Directions to “AFINNIECO ” Practice Location

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