Provider Demographics
NPI:1487981247
Name:JONES, KEITH L
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 S 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3707
Mailing Address - Country:US
Mailing Address - Phone:509-972-3734
Mailing Address - Fax:509-965-9998
Practice Address - Street 1:1019 S 48TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3707
Practice Address - Country:US
Practice Address - Phone:509-972-3734
Practice Address - Fax:509-965-9998
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-14
Last Update Date:2009-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies