Individual
AMANDA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60724
OR
225100000X
Physical Therapist
PT60509091
WA
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639572316
—
WA
01
—
P01461874
RR MEDICARE
WA
Enumeration date
10/08/2014
Last updated
03/04/2022
Update your record
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