Provider Demographics
NPI:1346819893
Name:TORRI, JORDAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:TORRI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5114 BRISTONWOOD DR W APT 111
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-1215
Mailing Address - Country:US
Mailing Address - Phone:630-202-5921
Mailing Address - Fax:
Practice Address - Street 1:22725 44TH AVE W STE 202
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-4500
Practice Address - Country:US
Practice Address - Phone:208-717-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-20
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61135362101YM0800X
WAPY61131690103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health