Individual
MS. TABATHA ANN JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4020 LEARY WAY NW, SUITE 100, SEATTLE, WA 98107-5002
(360) 402-9828
Mailing address
PO BOX 45444, SEATTLE, WA 98145-0444
(360) 402-9828
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60106755
WA
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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