Individual
DR. CAROL SUE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
4231 N INTERSTATE AVE, PORTLAND, OR 97217-3200
(503) 288-6066
Mailing address
4231 N INTERSTATE AVE, PORTLAND, OR 97217-3200
(503) 288-6066
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1973
OR
103T00000X
Psychologist
6301005104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035567000
BCBS
OR
01
—
680C946110
BCBSM
MI
Enumeration date
02/13/2007
Last updated
12/21/2010
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