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General NPI Number Information
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NPI Number | 1518785435
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Entity Type | Individual
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Provider Name | JACKY DEAN JONES PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 926 N 165TH ST
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City | SHORELINE
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State | WA
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Zip | 98133-5304
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Country | US
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Telephone | 360-328-6689
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Fax |
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Provider Business Mailing Address
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Address Line | 5611 40TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-2216
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Country | US
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Telephone | 360-328-6689
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT61559081
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License Number State | WA
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