Individual
AUSTIN DALE JENSEN
Active
Individual
AUSTIN DALE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
OD-61171154
WA
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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