Individual
SYRIANA ALYSE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6511 NE 18TH ST, VANCOUVER, WA 98661-6869
(360) 753-6082
Mailing address
6511 NE 18TH ST, VANCOUVER, WA 98661-6869
(360) 753-6082
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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