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Individual

CORY JAMES JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
601 W FRANCIS AVE, SPOKANE, WA 99205-6699
(509) 326-2772
Mailing address
52031 EAGLE VIEW LN, FORD, WA 99013-9517
(509) 844-5605

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60965247
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
JENSECJ102N2
DRIVER LICENSE
WA
Enumeration date
06/06/2019
Last updated
06/06/2019
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