Provider Demographics
NPI:1619659372
Name:UNDERDOWN, JOREL JIREH
Entity Type:Individual
Prefix:
First Name:JOREL
Middle Name:JIREH
Last Name:UNDERDOWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21002 135TH PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-3166
Mailing Address - Country:US
Mailing Address - Phone:509-361-9980
Mailing Address - Fax:
Practice Address - Street 1:21002 135TH PL SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-3166
Practice Address - Country:US
Practice Address - Phone:509-361-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter