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NPI Code Detail

MEDICARE: THEO WILLEY JONES SR.

MEDICARE: THEO WILLEY JONES SR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOR

General Provider Information

NPI Number : 1245176726
Entity Type Code : Individual
Provider Name (Legal Business Name) : THEO WILLEY JONES SR.
Provider Business Mailing Address
First Line : 8915 SW CENTER ST
Second Line :
City : TIGARD
State : OR
Zip : 97223-6307
Country : US
Telephone Number : 503-726-2740
Fax Number :
Provider Business Practice Location Address
First Line : 8915 SW CENTER ST # 97223
Second Line :
City : TIGARD
State : OR
Zip : 97223-6307
Country : US
Telephone Number : 503-726-3740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 04/27/2026

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Directions to “ THEO WILLEY JONES SR. ” Practice Location

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