Individual
RAY S JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
(206) 520-3186
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00032728
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00032728
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200JE
REGENCE
—
01
—
022278001
GROUP HEALTH
—
01
—
106607
H & I
WA
05
—
1255390761
—
WA
01
—
201454644
TAX ID
—
01
—
300066435
RAILROAD
WA
01
—
55900
H & I
WA
01
—
7098660
AETNA
—
05
—
7822109
—
WA
05
—
8188278
—
WA
01
—
910849248
TAX ID
—
01
—
JE4602
REGENCE
—
01
—
WE4663
REGENCE
—
Enumeration date
03/22/2006
Last updated
05/03/2018
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