Individual
JORDAN LEE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS. AAC
Contact information
Practice address
1710 ALLEN ST, KELSO, WA 98626-4907
(602) 617-0203
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC61475302
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60848399
WA
101YM0800X
Mental Health Counselor
MC61475302
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2064734
—
WA
Enumeration date
08/29/2016
Last updated
05/29/2025
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