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NPI Code Detail

MEDICARE: KATHRYNN JENSEN PA-C

MEDICARE: KATHRYNN JENSEN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA61247639WA

General Provider Information

NPI Number : 1922617489
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYNN JENSEN PA-C
Provider Business Mailing Address
First Line : 1793 13TH ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-2541
Country : US
Telephone Number : 503-362-8385
Fax Number : 503-362-8435
Provider Business Practice Location Address
First Line : 1740 COOKS HILL RD
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-9071
Country : US
Telephone Number : 971-915-8579
Fax Number : 425-970-4565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2020
Last Update Date : 06/10/2026

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Directions to “ KATHRYNN JENSEN PA-C” Practice Location

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