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Individual
JACKLYN GRACE JENSEN
Active
Individual
JACKLYN GRACE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
D-1292
ID
133V00000X
Registered Dietitian
Primary
DI61202063
WA
Other
Enumeration date
10/15/2021
Last updated
10/13/2022
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