Individual
JASEN SCOTT TENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTAL
Contact information
Practice address
700 VETERANS DRIVE, OREGON VETERANS HOME, THE DALLES, OR 97058
(971) 206-5129
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100 CONSONUS HEALTHCARE SERVICES, MILWAUKIE, OR 97222
(971) 206-5129
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10G7321
OR
224Z00000X
Occupational Therapy Assistant
OC00001108
WA
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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