Individual
MR. CHUCK RONALD JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
17801 108TH AVE SE, RENTON, WA 98055-6420
(425) 235-5383
Mailing address
4513 NE 25TH CT, RENTON, WA 98059-3533
(425) 235-6672
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00011778
WA
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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