Individual
BRUCE T JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
26129 CALVARY LN NE, SUITE 200, KINGSTON, WA 98346-7404
(360) 437-0331
(360) 297-7772
Mailing address
PO BOX 134, PORT GAMBLE, WA 98364-0134
(360) 437-0331
(360) 297-7772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
602049582
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225215288
NPI
WA
05
—
9049206
—
WA
Enumeration date
05/10/2006
Last updated
12/02/2011
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