Provider Demographics
NPI:1780279653
Name:FALOR, JORDAN ALLAINA (APRN)
Entity type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:ALLAINA
Last Name:FALOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:ALLAINA
Other - Last Name:BRISTOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11410 NE 122ND WAY
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6945
Mailing Address - Country:US
Mailing Address - Phone:801-678-2302
Mailing Address - Fax:
Practice Address - Street 1:11410 NE 122ND WAY
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6945
Practice Address - Country:US
Practice Address - Phone:801-678-2302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAN36115055363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty