Individual provider Active NPI

Audrey Jones, LE

  • Specialist
  • Vancouver, WA
National Provider Identifier
1700347804
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
BAP-E-10196159 Issued in OR
Practice address
2612 NE 114TH Ave Ste 1
Vancouver, WA 98684-4229
Phone
(503) 734-7764
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X BAP-E-10196159 OR Primary

Addresses

Primary practice location

2612 NE 114TH Ave Ste 1
Vancouver, WA 98684-4229

Mailing address

2847 Upper Dr
Lake Oswego, OR 97035-3663

Other practice location 1

18101 SW Boones Ferry Rd Ste 250
Portland, OR 97224-7655
Phone (503) 734-7764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BAP-E-10196159ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Northwest Electrology LLC Specialist CurrentSince Aug 7, 2022 Accepting new patients
Pacific Northwest Electrology LLC Specialist CurrentSince Jan 1, 2025 Accepting new patients

Locations

18101 SW Boones Ferry Rd
Ste 250
Portland, OR 97224
Phone (503) 734-7764

2612 NE 114th Ave
Ste 1
Vancouver, WA 98684
Phone (503) 734-7764

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1700347804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2847 UPPER DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 NE 114TH AVE STE 1",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844229",
            "telephone_number": "503-734-7764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 SW Boones Ferry Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972247655",
            "country_code": "US",
            "telephone_number": "503-734-7764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "AUDREY",
        "credential": "LE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "BAP-E-10196159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.