Individual
TYLER J JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4100 SW ALASKA ST STE B, SEATTLE, WA 98116-4527
(206) 320-3399
(206) 320-5506
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY61037683
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316600968
—
WA
Enumeration date
10/20/2021
Last updated
01/18/2022
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