Individual
MARY PHYLLIS JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP, MS
Contact information
Practice address
4690 NE NORTH TOLO RD, BAINBRIDGE ISLAND, WA 98110-1429
(206) 913-3236
Mailing address
4690 NE NORTH TOLO RD, BAINBRIDGE ISLAND, WA 98110-1429
(206) 913-3236
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002797
WA
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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