Individual
JORDAN TAKASUGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4205 KITSAP WAY, BREMERTON, WA 98312-2447
(360) 782-7780
(360) 782-7789
Mailing address
4205 KITSAP WAY, BREMERTON, WA 98312-2447
(360) 782-7780
(360) 782-7789
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
207P00000X
Emergency Medicine Physician
Primary
MD61502448
WA
Other
Enumeration date
09/27/2016
Last updated
04/13/2026
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