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Individual

MS. CAROLA JEAN JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8169
Mailing address
2592 FIR ST, NORTH BEND, OR 97459-1563
(541) 269-8485

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0000291
OR

Other

Enumeration date
09/06/2006
Last updated
07/08/2007
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