Jordan, Maudeen Grace
Jordan, Maudeen Grace is an sole proprietor health care provider with primary practice located at 2004 Main St Suite 203, Forest Grove OR 97116-2349. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jordan, Maudeen Grace can be contacted via phone (503) 998-6803.Contact Information
Primary practice address
2004 Main St Suite 203
Forest Grove OR 97116-2349
Phone: (503) 998-6803
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCSW 3139 | Oregon |
Profile Details
| NPI number | 1124286125 |
|---|---|
| LBN Legal business name | Jordan, Maudeen Grace |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 27th, 2008 |
| Last updated | May 27th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124286125 | NPPES |
| Oregon | Other | LCSW 3139 | LICENSE IN CLINICAL SOCIAL WORK |
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