Individual
MIRIAM A JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3250 HOSPITAL DRIVE, JUNEAU, AK 99801-9501
(907) 796-8654
(907) 586-5605
Mailing address
5931 MONTGOMERY ST, JUNEAU, AK 99801-9780
(907) 796-8654
(907) 586-5605
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841329356
—
AK
Enumeration date
03/02/2007
Last updated
02/05/2015
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