Doctor Name: | JORDAN KLEKAMP |
NPI Number: | 1194150730 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | CAAR.CG.60410095 |
Business Practice Address: | 300 Ocean Ave Raymond, WA - 985773016 |
Business Phone Number: | 3609422303 |
Business Fax Number: | |
Mailing Address: | 300 Ocean Ave, RAYMOND |
State: | WA |
Postal Code: | 985773016 |
Phone Number: | 3609422303 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2013 |
NPI Last Update Date: | 09/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CAAR.CG.60410095 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |