Provider Demographics
NPI:1730590894
Name:JONES, TRACY ANN (LMP)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 96TH ST S APT J108
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-1783
Mailing Address - Country:US
Mailing Address - Phone:253-592-3485
Mailing Address - Fax:
Practice Address - Street 1:2422 96TH ST S APT J108
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-1783
Practice Address - Country:US
Practice Address - Phone:253-389-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist