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1487167789
DOMINIQUE JORDAN
LAKEWOOD, WA
NPI
1487167789
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-11-08
Last Update Date
2017-11-08
Business Address
DOMINIQUE JORDAN BA
9330 59TH AVE SW
LAKEWOOD, WA 98499-2858
Phone number: 253-620-5015
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Mailing Address
DOMINIQUE JORDAN BA
9330 59TH AVE SW
LAKEWOOD, WA 98499-2858
Phone number:
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