Individual
JOHNNY MICHAEL JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
715 SEAFARERS WAY, STE 201 B, ANACORTES, WA 98221-2257
(360) 588-1460
(360) 588-1473
Mailing address
PO BOX 1048, ANACORTES, WA 98221-1048
(360) 588-1460
(360) 588-1473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PA10004470
WA
363A00000X
Physician Assistant
10004470
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174692198
—
WA
05
—
1174822159
—
WA
01
—
277551
STATE OF WA L & I
WA
Enumeration date
11/06/2006
Last updated
09/01/2011
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