Individual
MATTHEW JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1502 N LIBERTY LAKE RD, LIBERTY LAKE, WA 99019-8631
(509) 570-0485
Mailing address
1502 N LIBERTY LAKE RD, LIBERTY LAKE, WA 99019-8631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7089
ID
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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