DR. GLENN DAVIS JORDAN (NPI# 1043321276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043321276 |
| Entity Type | Individual |
| Full Name | DR. GLENN DAVIS JORDAN |
| Credential | MD |
| Practice Address |
315 Martin Luther King Jr Way Ms Z0 Ntl Tacoma WA 98405-4234 |
| Mailing Address |
8 33rd Avenue Ct Nw Gig Harbor WA 98335-7849 |
| Practice Telephone | 2534031019 |
| Mailing Telephone | 2534031019 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
MD00025749 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
315 MARTIN LUTHER KING JR WAY MS Z0 NTL |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811993298 | Catrina M. Funk | Obstetrics & Gynecology | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2005-06-22 |
| 1891301248 | Yaoyi Xiao | Pharmacist | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-09-21 |
| 1639782741 | Angie Kim Nguyen | Pediatrics | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-08-28 |
| 1720603558 | Louie Joseph Scalise II | Nurse Practitioner | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-06-08 |
| 1255951760 | Jamie R Sprague | Registered Nurse | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-04-24 |
| 1629606959 | Melissa Ann Sauvage | Pharmacist | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-03-31 |
| 1326675752 | Rajeshwari Shrestha | Nurse Practitioner | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-03-25 |
| 1013542422 | Heather Bahrt | Dietitian, Registered | 315 Martin Luther King Jr Way, Ms- 315c2hin, Tacoma, WA 98405-4234 | 2020-03-05 |
| 1457986150 | Deannita Fielding | Registered Nurse | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-03-03 |
| 1336789551 | Yuliana Garcia | Nurse Practitioner | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2020-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447200704 | Bruce Willham | Pediatrics | 315 M L King Jr Way, Attn: Pediatrix Medical Group, Tacoma, WA 98405-4234 | 2006-05-10 |
| 1417918160 | Delores Mary Gries | Pediatrics | 9040 Read St, Madigan Army Medical Center, Attn: Mchj-qcr, Tacoma, WA 98431-0001 | 2006-03-31 |
| 1255605374 | Jeanne Alexandra Krick | Pediatrics | 9040 Jackson Ave, Tacoma, WA 98431-1000 | 2012-03-07 |
| 1285899849 | Christina Marieke Long | Pediatrics | 9040 Reid St, Tacoma, WA 98431-1100 | 2008-07-23 |
| 1811192412 | Amy Marie Becker | Pediatrics | 9040 Jackson Ave, Tacoma, WA 98433 | 2007-06-15 |
| 1760444897 | Ray Y Sato | Pediatrics | 315 Martin Luther King Jr Way, Ms Z0-ntl, Tacoma, WA 98405-4234 | 2006-04-04 |
| 1528031242 | Timothy Francis Haley | Pediatrics | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2006-02-13 |
| 1578559217 | John Sterling Golden | Pediatrics | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417118399 | Claudia Nadernejad | Pediatrics | 35 W 8th Ave Ste 442, Spokane, WA 99204-2361 | 2008-06-23 |
| 1316151376 | Jeff Yuan | Pediatrics | 6601 Cascade Ave, Gig Harbor, WA 98335-1971 | 2007-05-09 |
| 1356453708 | Ashraf Adib Morkos | Pediatrics | 17209 Se 57th Pl, Bellevue, WA 98006-5952 | 2006-08-31 |
| 1730295569 | Gary A Twiggs | Pediatrics | 3626 Ne 45th Street, Suite 300, Seattle, WA 98105-5643 | 2006-08-22 |
| 1013932680 | Dennis Mayock | Pediatrics | Pediatrics, Box 356320, University of Washington, Seattle, WA 98195-6320 | 2006-07-13 |
| 1942262027 | Ron C Ilg | Pediatrics | 35 W 8th Ave, Suite 440, Spokane, WA 99204-2361 | 2006-04-05 |
| 1154766699 | Min Ji Hwang | Pediatrics | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2013-05-09 |
| 1881960268 | Mihai Puia-dumitrescu | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2012-03-29 |
| 1780972638 | Cherrie Rose Tan Dy | Pediatrics | 400 S 43rd St, Renton, WA 98055-5714 | 2011-07-13 |
| 1548556376 | Claudia Weinheimer | Pediatrics | 35 W 8th Ave Ste 442, Spokane, WA 99204-2361 | 2011-06-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.