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Individual
LISA ELAINE JORDAN
Active
Individual
LISA ELAINE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61067579
WA
Other
Enumeration date
04/20/2020
Last updated
04/03/2024
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