Provider Demographics
NPI:1720786908
Name:LUMBY, JORDYN (CPC)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:
Last Name:LUMBY
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3004
Mailing Address - Country:US
Mailing Address - Phone:253-785-9218
Mailing Address - Fax:253-200-0636
Practice Address - Street 1:2156 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3004
Practice Address - Country:US
Practice Address - Phone:253-785-9218
Practice Address - Fax:253-200-0636
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist