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General NPI Number Information
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NPI Number | 1861355943
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Entity Type | Individual
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Provider Name | JORDAN SKAN
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Gender | Male
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 905 RICHARDSON VISTA RD APT 158
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City | ANCHORAGE
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State | AK
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Zip | 99501-1519
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Country | US
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Telephone | 907-463-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 905 RICHARDSON VISTA RD APT 158
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City | ANCHORAGE
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State | AK
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Zip | 99501-1519
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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