Individual
RICHARD ALLAN JENSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SUITE 4300, SPOKANE, WA 99204-2307
(509) 747-6707
(509) 624-9186
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 474-6707
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
M-9469
ID
2080P0202X
Pediatric Cardiology Physician
Primary
MD00042494
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149736
—
MT
05
—
2277230
—
OR
05
—
806634500
—
ID
05
—
8357667
—
WA
Enumeration date
05/18/2006
Last updated
06/02/2021
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