Jordan M Hendrickson PSYD

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JORDAN M HENDRICKSON PSYD

Practice address

4400 NE 77TH Ave Ste 275
Vancouver, WA 98662-6857

Phone

(503) 709-3295

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jordan M Hendrickson, PSYDNPI 1437452018

Title

Psychologist/Owner

Phone

(503) 709-3295

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan Michelle Hendrickson, PSYD

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1437452018
  NPD Authorized official

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1861162844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 NE 77TH AVE STE 275",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626857",
            "telephone_number": "503-709-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 NE 77TH AVE STE 275",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626857",
            "telephone_number": "503-709-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN M HENDRICKSON PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "503-709-3295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jones, Tara
• Tawna Jones, OT
• Trevor James Jones, CDPT
• Trisha Auvyn Jones, C.HT., NLP, CLERGY
• Ann Marie Jonsson, RN
• Melinda Jean Jordan-Martin, PA.C
• Andrea Jordan, LMHC
• Carolrene Reychelle Jordan
• Craig William Jordan, OD
• Jamie L Jordan, PMHNP

• Community/Behavioral Health Agency in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.