Provider Demographics
NPI:1881975340
Name:DUNCAN, JORDAN DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:DANIEL
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:TRACYTON
Mailing Address - State:WA
Mailing Address - Zip Code:98393-0209
Mailing Address - Country:US
Mailing Address - Phone:360-620-8487
Mailing Address - Fax:
Practice Address - Street 1:1111 NE RIDDELL RD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3039
Practice Address - Country:US
Practice Address - Phone:360-479-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60238072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor