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Individual

JORDAN NEISTAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NBC-HWC

Contact information

Practice address
20444 BRENTWOOD AVE, BEND, OR 97702-3289
(617) 595-5990
Mailing address
20444 BRENTWOOD AVE, BEND, OR 97702-3289

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
A-3785068

Other

Enumeration date
11/01/2023
Last updated
11/01/2023
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