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Individual

DR. RICHARD FREDERICK JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
7922 OLYMPIC VIEW DR NW, GIG HARBOR, WA 98335-6275
(253) 358-6640
(253) 851-3188
Mailing address
7922 OLYMPIC VIEW DR NW, GIG HARBOR, WA 98335-6275
(253) 358-6640
(253) 851-3188

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY00000987
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7017544
WA
01
G001001904
MEDICARE PTAN
Enumeration date
09/16/2006
Last updated
03/24/2021
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