Provider Demographics
NPI:1467570457
Name:JORDAN, ELINOR ELISABETH (ND)
Entity Type:Individual
Prefix:
First Name:ELINOR
Middle Name:ELISABETH
Last Name:JORDAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PEAR ST NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-3939
Mailing Address - Country:US
Mailing Address - Phone:360-790-3379
Mailing Address - Fax:360-705-0112
Practice Address - Street 1:120 PEAR ST NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-3939
Practice Address - Country:US
Practice Address - Phone:360-790-3379
Practice Address - Fax:360-705-0112
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1053175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1053OtherLICENSE NUMBER
WA1053OtherLICENSE NUMBER