Individual
JORDAN MICHELLE PANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40903 236TH AVE SE, ENUMCLAW, WA 98022-8606
(360) 825-6525
Mailing address
40903 236TH AVE SE, ENUMCLAW, WA 98022-8606
(360) 825-6525
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60242155
WA
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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