Individual
AUDREY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LE
Contact information
Practice address
2612 NE 114TH AVE STE 1, VANCOUVER, WA 98684-4229
(503) 734-7764
Mailing address
2847 UPPER DR, LAKE OSWEGO, OR 97035-3663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAP-E-10196159
OR
Other
Enumeration date
03/29/2019
Last updated
08/12/2024
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