Individual
MS. VIDA MAE JORDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 255-4205
Mailing address
2339 SE 92ND AVE, PORTLAND, OR 97216-2030
(503) 806-9768
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
OR
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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