Provider Demographics
NPI:1487362497
Name:JONES, NICHOLAS (RPH)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-1864
Mailing Address - Country:US
Mailing Address - Phone:541-278-4285
Mailing Address - Fax:541-278-4288
Practice Address - Street 1:201 SW 20TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-1864
Practice Address - Country:US
Practice Address - Phone:541-278-4285
Practice Address - Fax:541-278-4288
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist