Individual
MR. JORDAN MOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
505 NE 87TH AVE STE 301, VANCOUVER, WA 98664-1965
(360) 514-1854
(360) 514-6063
Mailing address
140 WOODLYN AVE, WILLOW GROVE, PA 19090-3736
(267) 702-0323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
MM2292186
WA
363LF0000X
Family Nurse Practitioner
SP010707
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021036480001
—
PA
Enumeration date
02/15/2010
Last updated
11/18/2020
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