Betty Jordan, CERTIFIED NURSING AS

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

NC60985625 Issued in WA

Practice address

4102 Cliff Dr
Everett, WA 98203-1835

Phone

(425) 246-3972

Fax

(425) 903-4727

NPI assigned

Jan 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Science

State licenses

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1538709274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 CLIFF DR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031835",
            "telephone_number": "425-246-3972",
            "fax_number": "425-903-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 CLIFF DR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031835",
            "telephone_number": "425-246-3972",
            "fax_number": "425-903-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "BETTY",
        "credential": "CERTIFIED NURSING AS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "NC60985625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas W Jones Jr., M.D.
• Tia Jones, LMP
• Timothy Jones, PA-C
• SE Jin Joo, DDS
• Betti Jean Jordan, RC00035276
• Candace Lee Jordan, LMP
• Elnora Jo Jordan, M.S.
• James William Jordan, M.D.
• John D Jordan, MD
• Kristen Jordan

• Adult Care Home Facility in Everett, WA
• Providers in Everett, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.