Individual
JORDAN HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(309) 830-8996
Mailing address
1959 NE PACIFIC STREET; BOX 357134, SEATTLE, WA 98195-0001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DR60950171
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2019
Last updated
07/04/2019
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