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General NPI Number Information
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NPI Number | 1861050833
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Entity Type | Individual
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Provider Name | KAYLIE MARIE JONES
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Gender | Female
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 822 N 10TH PL STE A
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City | RENTON
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State | WA
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Zip | 98057-5593
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Country | US
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Telephone | 425-276-5752
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Fax | 425-207-8829
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Provider Business Mailing Address
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Address Line | 822 N 10TH PL STE A
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City | RENTON
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State | WA
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Zip | 98057-5593
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Country | US
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Telephone | 425-276-5752
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Fax | 425-207-8829
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO60961368
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License Number State | WA
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