Individual
CAROLYN S JORGENSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
201 160TH ST S, SUITE 301, SPANAWAY, WA 98387-8508
(253) 531-4100
(253) 531-3795
Mailing address
201 160TH ST S, SUITE 301, SPANAWAY, WA 98387-8508
(253) 531-4100
(253) 531-3795
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003420
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59042
STATE WORKERS COMP #
WA
05
—
8334377
—
WA
01
—
JO2103
REGENCE BLUE SHIELD
WA
Enumeration date
12/02/2005
Last updated
07/09/2007
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