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Individual
MR. CRAIG MICHAEL JORDAN
Active
Individual
MR. CRAIG MICHAEL JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13357
MA
225X00000X
Occupational Therapist
OT00004127
WA
225XH1200X
Hand Occupational Therapist
1839
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8902680
MEDICARE
WA
Enumeration date
05/01/2007
Last updated
10/21/2019
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