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General NPI Number Information
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NPI Number | 1285960419
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Entity Type | Individual
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Provider Name | LAURA ASHLEY JONES LMT
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Gender | Female
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 2285 NW JOHNSON ST
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City | PORTLAND
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State | OR
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Zip | 97210-3236
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Country | US
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Telephone | 210-445-5870
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Fax |
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Provider Business Mailing Address
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Address Line | 306 N RUSSET ST
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City | PORTLAND
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State | OR
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Zip | 97217-1410
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Country | US
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Telephone | 210-445-5870
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 12328
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 00024881
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 045095
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License Number State | TX
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