Individual
JORDAN JAY SLATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18422 103RD AVE NE, BOTHELL, WA 98011-3410
(425) 949-0801
Mailing address
1703 127TH PL SE, EVERETT, WA 98208-6516
(254) 248-9273
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/11/2021
Last updated
10/05/2022
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