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General NPI Number Information
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NPI Number | 1316874605
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Entity Type | Individual
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Provider Name | HOLLY JORDAN RN
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Gender | Female
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 751 NE 59TH ST
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City | SEATTLE
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State | WA
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Zip | 98105-2757
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Country | US
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Telephone | 253-422-3494
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Fax | 844-440-1716
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Provider Business Mailing Address
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Address Line | 2071 N FORK DR
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City | LAFAYETTE
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State | CO
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Zip | 80026-3132
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Country | US
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Telephone | 253-422-3494
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Fax | 844-440-1716
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 61538657
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License Number State | WA
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