# JENNIFER KOCH, PSY.D., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bloom and Blossom Wellness Spa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184355562
- **Authorized official:** DR. JENNIFER KOCH PSY.D. (PSYCHOLOGIST/OWNER)
- **Authorized official phone:** (360) 706-2674

## Contact information

- **Practice address:** 111 TUMWATER BLVD SE STE C213, TUMWATER, WA 98501-6400
- **Practice address phone:** (360) 706-2674
- **Practice address fax:** (360) 634-3565
- **Mailing address:** 111 TUMWATER BLVD SE STE C213, TUMWATER, WA 98501-6400
- **Mailing address phone:** (360) 706-2674
- **Mailing address fax:** (360) 634-3565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 06/17/2022
- **Last updated:** 07/01/2022