Individual
JESSE T. FENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
19245 7TH AVE NE, POULSBO, WA 98370-6651
(360) 782-3500
(360) 782-3540
Mailing address
2512 WHEATON WAY, BREMERTON, WA 98310-3399
(360) 782-3650
(360) 782-3686
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
—
—
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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