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General NPI Number Information
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NPI Number | 1689554420
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Entity Type | Individual
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Provider Name | KAITLYN LAVERNE TIESKIE JONES PA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 4311 11TH AVE NE STE 200
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City | SEATTLE
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State | WA
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Zip | 98105-6367
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Country | US
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Telephone | 206-616-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 20200 54TH AVE W
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City | LYNNWOOD
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State | WA
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Zip | 98036-6389
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Country | US
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Telephone | 877-828-4510
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Fax | 877-899-4994
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA70039479
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License Number State | WA
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