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Individual

JORDAN MICHELLE HENDRICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
4400 NE 77TH AVE STE 275, VANCOUVER, WA 98662-6857
(503) 709-3295
Mailing address
4400 NE 77TH AVE STE 275, VANCOUVER, WA 98662-6857
(503) 709-3295

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2608
OR
103TC0700X
Clinical Psychologist
PSYPSYLIC3612
MT
103TC0700X
Clinical Psychologist
PY60949986
WA

Other

Enumeration date
12/21/2010
Last updated
09/28/2021
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