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NPI Code Detail

MEDICARE: MARCIA C, JORDAN M.D.

MEDICARE:   MARCIA C, JORDAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00031325WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558331454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIA C, JORDAN M.D.
Provider Business Mailing Address
First Line : 1412 SW 43RD ST
Second Line : #200
City : RENTON
State : WA
Zip : 98057-4803
Country : US
Telephone Number : 425-271-4910
Fax Number : 425-264-1041
Provider Business Practice Location Address
First Line : 1412 SW 43RD ST
Second Line : #200
City : RENTON
State : WA
Zip : 98057-4803
Country : US
Telephone Number : 425-271-4910
Fax Number : 425-264-1041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 12/28/2016

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Directions to “ MARCIA C, JORDAN M.D.” Practice Location

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