NPI 1154921054

Carolrene Reychelle Jordan

Practitioner Other Specialist/Technologist Vancouver, WA

Practice location

Address: 9015 E Mill Plain Blvd, Vancouver, WA 98664-2536
Phone: (360) 773-5110

Registered specialties

Other Specialist/Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246Z00000X Licence 89329 (WA)

Other Specialist/Technologist, Other providers in Washington →

Registry record

NPI: 1154921054
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Oct 2020
Record last updated: 29 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.