Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 60320009 | WA |
NPI | 1326275553 |
---|---|
Provider Name | Mrs. Chelsea Lynee Jordan |
First Address | Tacoma, WA 98431-3440 |
Second Address | Tacoma, WA 98431-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2009 |
Last Update Date | 27/01/2021 |