Individual
JORDAN BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5736 NE GLISAN ST, PORTLAND, OR 97213-3750
(503) 863-5880
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60454
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500668792
—
OR
01
—
R195466
MEDICARE
OR
Enumeration date
02/06/2014
Last updated
03/10/2026
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