Organization
CONNIE E. JENSEN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE E JENSEN CRNA (PROVIDER/OWNER)
(253) 588-7911
Entity
Organization
Contact information
Practice address
502 S M ST STE 200, TACOMA, WA 98405-3728
(253) 588-7911
(253) 984-6774
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
(253) 984-6774
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005224
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP30005224
MEDICAL LICENSE
WA
Enumeration date
01/14/2011
Last updated
01/14/2011
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