Individual
JORDAN JAMES ALLENSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
417 SE 164TH AVE STE 300, VANCOUVER, WA 98684-8944
(360) 256-4425
(360) 256-2474
Mailing address
3181 SW SAM JACKSON PARK RD, OHSU, PORTLAND, OR 97239-3011
(503) 494-8220
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD61144936
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/26/2013
Last updated
07/16/2021
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