Jordan Andersen Lander, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60198654 Issued in WA

Practice address

6601 220TH St SW
Suite 1
Mountlake Terrace, WA 98043-2166

Phone

(425) 775-7274

Fax

(425) 775-0963

NPI assigned

Jan 13, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1437454972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 BYRON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091505",
            "telephone_number": "803-608-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 220TH ST SW",
            "address_2": "SUITE 1",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432166",
            "telephone_number": "425-775-7274",
            "fax_number": "425-775-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDER",
        "first_name": "JORDAN",
        "middle_name": "ANDERSEN",
        "name_prefix": "Mr.",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60198654",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.