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Jordan Southern
Student in an Organized Health Care Education/Training Program in Chehalis, Washington
NPI 1558089300

Jordan Southern is a Student in an Organized Health Care Education/Training Program based in Chehalis, WA. Jordan Southern practices in Chehalis, WA. The NPI Number for Jordan Southern is 1558089300 and holds a License No. (Washington).

The current practice location address for Jordan Southern is 135 W Main St, Chehalis, WA and can be reached out via phone at 360-748-4339. You can also correspond with Jordan Southern through the mailing address at 615B KOONTZ RD, CHEHALIS, WA - 98532-8436 (mailing address contact number: ).

Location: 135 W Main St, Chehalis, WA, 98532-8436
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558089300
Provider Name
Jordan Southern
Credential
Provider Entity Type
Individual
Gender
Female
Address
135 W Main St, Chehalis, WA, 98532-8436
Phone Number
360-748-4339
Fax Number
Provider Enumeration Date
08/18/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
135 W Main St
City
Chehalis
State
Washington
Zip
98532-4817
Phone Number
360-748-4339
Fax Number
person
Provider Business Mailing Address Details
Address
135 W Main St
City
Chehalis
State
Washington
Zip
98532-4817
Phone Number
360-748-4339
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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