Individual
MS. DANIELLE LOUISE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5249
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
GROUP NPI-NORTH BEND MEDICAL CENTER
OR
01
—
161133
GROUP MEDICAID-NORTH BEND MEDICAL CENTER
OR
05
—
247425
—
OR
01
—
930635514
GROUP TAX ID - NORTH BEND MEDICAL CENTER
OR
01
—
R0000WFBTV
GROUP-MEDICARE-NORTH BEND MEDICAL CENTER
OR
Enumeration date
09/26/2006
Last updated
03/25/2016
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