Individual
MR. BRAD LANCE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4776
Mailing address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60185873
WA
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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