Individual
MR. JORDAN DAVID MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
17150 W MAIN ST STE B, MONROE, WA 98272-1918
(360) 294-8480
Mailing address
909 W MAIN ST STE 102, MONROE, WA 98272-2031
(206) 552-0882
(949) 955-5758
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60505994
WA
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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