Provider Demographics
NPI:1750871620
Name:JONES, DEMI S (BA)
Entity type:Individual
Prefix:
First Name:DEMI
Middle Name:S
Last Name:JONES
Suffix:
Gender:
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17650 134TH AVE SE APT H101
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6891
Mailing Address - Country:US
Mailing Address - Phone:904-576-3284
Mailing Address - Fax:
Practice Address - Street 1:17650 134TH AVE SE APT H101
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-6891
Practice Address - Country:US
Practice Address - Phone:904-576-3284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WAMC61451272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator