Individual
JORDAN MARIE JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6821 NE 181ST ST STE 102, KENMORE, WA 98028-5044
(425) 486-9211
Mailing address
6307 BERKSHIRE DR # B, EVERETT, WA 98203-4658
(425) 770-3652
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
60768586
WA
124Q00000X
Dental Hygienist
H009424
AZ
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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