SYRIANA ALYSE JORDAN (NPI# 1104215615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104215615 |
| Entity Type | Individual |
| Full Name | SYRIANA ALYSE JORDAN |
| Practice Address |
6511 Ne 18th St Vancouver WA 98661-6869 |
| Practice Telephone | 3607536082 |
| Mailing Telephone | 3607536082 |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
6511 NE 18TH ST |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98661-6869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033328687 | Tracy Lee Moser | Speech-Language Pathologist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2007-05-21 |
| 1497207781 | Autism Empowerment | Voluntary or Charitable | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2016-11-02 |
| 1629461355 | Harold Christopher Clark II | Custodial Care Facility | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2015-03-04 |
| 1619297967 | Jillian Nicole Sivinski | Occupational Therapist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2010-06-09 |
| 1255654596 | Angela Gayle Paterson | Speech-Language Pathologist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2010-03-01 |
| 1376872929 | Arc of Clark County | Day Training, Developmentally Disabled Services | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2009-12-10 |
| 1295960144 | Jacqueline Kay Diercks | Speech-Language Pathologist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2009-05-21 |
| 1659529824 | Erin Kathleen Bompiani | Physical Therapist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2008-08-30 |
| 1477724292 | Mary E Kilway | Speech-Language Pathologist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2008-03-19 |
| 1821269648 | Brigetta C Isom | Speech-Language Pathologist | 6511 Ne 18th St, Vancouver, WA 98661-6869 | 2008-03-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228417 | Cynthia Ann Holt | Social Worker | 4608 Ne 47 Street, Vancouver, WA 98661 | 2020-06-01 |
| 1235793027 | James Dostert | Counselor | 1601 E 4th Blvd. Bldg. 17, Ste A212, Vancouver, WA 98661 | 2019-04-26 |
| 1306305289 | Kathryn Susanne Scott | Social Worker | Attn: Kathryn Scott, V3cnh, 1601 E. Fourth Plain Blvd., Vancouver, WA 98661 | 2019-03-19 |
| 1952860637 | Alice Rogers | Occupational Therapist | Vancouver Public Schools, 2901 Falk Rd., Vancouver, WA 98661 | 2019-03-13 |
| 1053878538 | Paula Moore | Counselor | 9626 Ne Fourth Plain Blvd, Vancouver, WA 98661 | 2019-02-21 |
| 1558825729 | Cassandra Marie Nichols | Counselor | 1601 E 4th Blvd, Vancouver, WA 98661 | 2019-01-22 |
| 1548734148 | Lisa Kelly | Counselor | 1601 E 4th Blvd., Vancouver, WA 98661 | 2019-01-16 |
| 1518444025 | Columbia Pharmacy | Pharmacy | 2700 Ne Andresen Rd Ste E3, Vancouver, WA 98661 | 2018-07-26 |
| 1023505229 | Ellen Barbour | Counselor | 1601 E 4th Plain Blvd Bldg. 17, Ste A212, Vancouver, WA 98661 | 2018-04-13 |
| 1679096325 | Brian Scott Coleman | Counselor | 1601 East Fourth Plain Blvd., Bldg #17, Ste. A212, Vancouver, WA 98661 | 2017-07-24 |
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| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548804578 | Aurita Estudillo Tagle | Custodial Care Facility | 7015 Carolina Ln, Vancouver, WA 98664-1558 | 2019-11-02 |
| 1427516962 | Evangeline Royon Plunkett | Custodial Care Facility | 5912 Ne 112th St, Vancouver, WA 98686-5953 | 2019-03-04 |
| 1801302419 | Aleksandr Marchuk | Custodial Care Facility | 14807 Ne 87th St, Vancouver, WA 98682-3443 | 2017-12-19 |
| 1164803383 | Rite Choice Ventilator Specialty LLC Afh | Custodial Care Facility | 15208 Ne 25th Cir, Vancouver, WA 98684-7884 | 2015-06-12 |
| 1568862134 | Divinity Adult Family Home, LLC | Custodial Care Facility | 5902 Kansas St, Vancouver, WA 98661-6918 | 2014-09-02 |
| 1154737930 | Diana Mocan | Custodial Care Facility | 3911 Se 157th Ave, Vancouver, WA 98683-5310 | 2014-07-01 |
| 1366865644 | Lilia L. Ortega Rnd | Custodial Care Facility | 3703 Columbia St, Vancouver, WA 98660-1965 | 2014-01-23 |
| 1396179222 | Jg&m Corporation | Custodial Care Facility | 9600 Ne 113th Ave, Vancouver, WA 98662-2258 | 2013-08-28 |
| 1326484080 | Precious Jewel Adult Family Home | Custodial Care Facility | 9707 Ne 115th Ct, Vancouver, WA 98662 | 2013-05-21 |
| 1922391408 | Evergreen Quality Home | Custodial Care Facility | 304 Nw 102nd St, Vancouver, WA 98685-5233 | 2011-05-17 |
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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.