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Individual

MELANIE JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
900 7TH ST, CLARKSTON, WA 99403-2005
(509) 758-3341
(509) 769-6057
Mailing address
900 7TH ST, CLARKSTON, WA 99403-2005
(509) 758-3341
(509) 769-6057

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60498949
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000001
ST OF WA
WA
Enumeration date
02/17/2016
Last updated
02/17/2016
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