Individual
MR. ANTHONY CARROLL JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
1427 JEFFERSON AVE, SUITE 101, ENUMCLAW, WA 98022-3649
(360) 825-4466
Mailing address
1427 JEFFERSON AVE, SUITE 101, ENUMCLAW, WA 98022-3649
(360) 825-4466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
WA
Other
Enumeration date
08/19/2014
Last updated
09/23/2014
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