Individual
MR. ANTHONY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
99-11-27
OR
Other
Enumeration date
03/20/2014
Last updated
09/26/2014
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