Healthcare Provider Details

I. General information

NPI: 1417693581
Provider Name (Legal Business Name): JORDYN GIFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S 320TH ST STE A
FEDERAL WAY WA
98003-4691
US

IV. Provider business mailing address

700 S 320TH ST STE A
FEDERAL WAY WA
98003-4691
US

V. Phone/Fax

Practice location:
  • Phone: 253-246-2435
  • Fax: 253-838-1433
Mailing address:
  • Phone: 253-246-2435
  • Fax: 253-838-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number61445424
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC61445424
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: