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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124286125 NPPES
Oregon Other LCSW 3139 LICENSE IN CLINICAL SOCIAL WORK

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