Individual
GWYNETH THERESA JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP
Contact information
Practice address
1410 NE 106TH AVE, PORTLAND, OR 97220-3934
(503) 460-0405
(503) 460-0434
Mailing address
319 SE 81ST AVE, PORTLAND, OR 97215-1534
(503) 734-5487
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
363LF0000X
Family Nurse Practitioner
Primary
201506920NP-PP
OR
372600000X
Adult Companion
—
—
Other
Enumeration date
01/22/2007
Last updated
09/16/2015
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