Individual
LARRY J JORDAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(650) 283-1592
Mailing address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(650) 283-1592
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LP.61501117
WA
Other
Enumeration date
02/23/2024
Last updated
02/26/2024
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