Individual
FREDRICK JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 S PROCTOR ST, TACOMA, WA 98405-2047
(253) 396-5822
Mailing address
15333 RAINIER VIEW LN SE, YELM, WA 98597
(360) 480-8752
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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