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General NPI Number Information
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NPI Number | 1285394759
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Entity Type | Individual
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Provider Name | JORDANNE PAIGE TODD PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/27/2021
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 7096 LAKELAND HILLS WAY SE STE 103
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City | AUBURN
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State | WA
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Zip | 98092-8438
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Country | US
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Telephone | 253-545-3650
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Fax |
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Provider Business Mailing Address
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Address Line | 2326 19TH STREET PL SE
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City | PUYALLUP
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State | WA
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Zip | 98374-1461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 61228215
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License Number State | WA
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