Individual
HEATHER MELLEN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 361-5400
Mailing address
31070 SW WILLAMETTE WAY W, WILSONVILLE, OR 97070-9565
(503) 860-2084
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3168ATI
OR
152W00000X
Optometrist
OD00004093
WA
Other
Enumeration date
09/01/2006
Last updated
10/05/2009
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