Southern, Jordan

Southern, Jordan is an individual health care provider with primary practice located at 135 W Main St , Chehalis WA 98532-4817. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Southern, Jordan can be contacted via phone (360) 748-4339.

Contact Information

Primary practice address
135 W Main St Chehalis WA 98532-4817
Phone: (360) 748-4339
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1558089300
LBN Legal business name Southern, Jordan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2022
Last updated Aug 18th, 2022 - about 4 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.

Request for update

Popular Providers