Individual
MICHAEL J JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
202 CROSS ST SE, AUBURN, WA 98002-5406
(253) 876-8111
Mailing address
202 CROSS ST SE, AUBURN, WA 98002-5406
(253) 876-8111
(253) 876-8211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60055107
WA
363AM0700X
Medical Physician Assistant
1469
OK
363AM0700X
Medical Physician Assistant
PA60055107
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200069430A
—
OK
01
—
P00363323
MEDICARE RAILROAD
OK
Enumeration date
01/26/2006
Last updated
04/19/2011
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