Provider Demographics
NPI:1659930170
Name:JIN, JORDAN E (OD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:E
Last Name:JIN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 NE 8TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4115
Mailing Address - Country:US
Mailing Address - Phone:425-746-2122
Mailing Address - Fax:206-624-0463
Practice Address - Street 1:14700 NE 8TH ST STE 105
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4115
Practice Address - Country:US
Practice Address - Phone:425-746-2122
Practice Address - Fax:206-624-0463
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-08
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60962143152W00000X
WAOD60962143152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist