Individual
JORDAN LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8332 N DICKENS ST, PORTLAND, OR 97203-3020
(630) 346-5088
Mailing address
8332 N DICKENS ST, PORTLAND, OR 97203-3020
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15364
OR
235Z00000X
Speech-Language Pathologist
LL60491167
WA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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