Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 201471J | WA |
NPI | 1013267772 |
---|---|
Provider Name | Mr. John Owen Jones |
First Address | Hoquiam, WA 98550-2762 |
Second Address | Hoquiam, WA 98550-2762 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2012 |
Last Update Date | 10/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201471J | SUPREINTENDENT OF PUBLIC INSTRUCTION (01) | WA |