Organization
JENTERPRISES PS
Active
Other names
Renton Vision Source
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL SCOTT JENSEN O.D. (PRESIDENT)
(425) 255-2020
Entity
Organization
Contact information
Practice address
112 PELLY AVE N, RENTON, WA 98057-5713
(425) 255-2020
(425) 255-2028
Mailing address
PO BOX 353, RENTON, WA 98057-0353
(425) 255-2020
(425) 255-2028
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1722 TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021467
—
WA
Enumeration date
12/20/2006
Last updated
07/16/2008
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