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Individual

TONIA LARISSA JENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP00001783
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0256463
STATE L&I
WA
05
1036849
WA
Enumeration date
09/16/2009
Last updated
12/04/2020
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