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Individual
JESSE T. FENGER
Active
Individual
JESSE T. FENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
—
NULL
363A00000X
Physician Assistant
728
AK
363A00000X
Physician Assistant
Primary
PA-10005297
WA
Other
Enumeration date
10/24/2006
Last updated
01/23/2012
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