Healthcare Provider Details

I. General information

NPI: 1740199868
Provider Name (Legal Business Name): ANNETTE JONES CPSS.PR.70177059
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34617 11TH AVE S STE 301
FEDERAL WAY WA
98003-8706
US

IV. Provider business mailing address

34617 11TH AVE S STE 301
FEDERAL WAY WA
98003-8706
US

V. Phone/Fax

Practice location:
  • Phone: 206-602-8215
  • Fax:
Mailing address:
  • Phone: 206-602-8215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCPSS.PR.70177059
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: