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Individual

JORDAN WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
201 160TH ST S, STE. 301, SPANAWAY, WA 98387-8508
(253) 531-4100
(253) 531-3795
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60665703
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DI60665703
STATE LICENSE
WA
Enumeration date
08/01/2016
Last updated
08/01/2016
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