Jordan Southern, is a
Student In An Organized Health Care Education/training Program based in Chehalis, Washington. Jordan Southern is licensed to practice in * (Not Available) (license number ) and her current practice location is
135 W Main St, Chehalis, Washington. She can be reached at her office (for appointments etc.) via phone at
(360) 748-4339.
NPI number for Jordan Southern is 1558089300 and her current mailing address is 615b Koontz Rd, Chehalis, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1558089300.
Healthcare Provider's Profile
Full Name | Jordan Southern |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 135 W Main St, Chehalis, Washington |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1558089300
- Provider Enumeration Date: 08/18/2022
- Last Update Date: 08/18/2022
Medical Identifiers
Medical identifiers for Jordan Southern such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1558089300 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jordan Southern is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jordan Southern, 615b Koontz Rd, Chehalis, WA 98532-8436 Ph: () - | Jordan Southern, 135 W Main St, Chehalis, WA 98532-4817 Ph: (360) 748-4339 |
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