Provider Demographics
NPI:1679890651
Name:JONES REDSTONE, CAROLINE (DNP, PMHNP, CNM, RN)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:JONES REDSTONE
Suffix:
Gender:F
Credentials:DNP, PMHNP, CNM, RN
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNM
Mailing Address - Street 1:3519 NE 15TH AVE # 247
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2356
Mailing Address - Country:US
Mailing Address - Phone:503-719-8865
Mailing Address - Fax:503-384-2608
Practice Address - Street 1:3000 NE 41ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2905
Practice Address - Country:US
Practice Address - Phone:503-719-8865
Practice Address - Fax:503-384-2608
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200950018363LP0808X, 367A00000X
WARN61119032163W00000X
WAAP61123766-NP363LP0808X
OR200140762163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health