Individual
MS. STACEY MARIE JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
73265 CONFEDERATED WAY, PENDLETON, OR 97801-0160
(541) 966-9830
Mailing address
117 NW 7TH ST, PO BOX 1938, PENDLETON, OR 97801-1506
(541) 240-1603
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200730406LPN
OR
164W00000X
Licensed Practical Nurse
LP0055060
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1741037
—
OR
Enumeration date
10/25/2010
Last updated
10/25/2010
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