Individual
MARTHA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
210 128TH ST SE, EVERETT, WA 98208-6338
(425) 337-5100
Mailing address
14112 1ST AVE W, EVERETT, WA 98208-6963
(425) 787-0258
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA0003543
WA
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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