Individual
TODD JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
BUILDING 03669 RAILROAD AVE, JOINT BASE LEWIS-MCCHORD, WA 98430
(719) 351-5925
Mailing address
2831 ANNA ST NE, LACEY, WA 98516-4106
(719) 351-5925
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160844217
WA
Other
Enumeration date
03/05/2018
Last updated
11/01/2022
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