Provider Demographics
NPI:1225518657
Name:CHIEROTTI, JORDAN RYLEE (CB60887865)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:RYLEE
Last Name:CHIEROTTI
Suffix:
Gender:F
Credentials:CB60887865
Other - Prefix:MS
Other - First Name:JAY
Other - Middle Name:RYLEE
Other - Last Name:CHIEROTTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4238 AUBURN WAY N
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-1311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4238 AUBURN WAY N
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002
Practice Address - Country:US
Practice Address - Phone:253-876-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst