Healthcare Provider Details

I. General information

NPI: 1215648381
Provider Name (Legal Business Name): JENSEN WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N CURTIS RD
BOISE ID
83706-1445
US

IV. Provider business mailing address

PO BOX 8111
BOISE ID
83707-2111
US

V. Phone/Fax

Practice location:
  • Phone: 208-605-3000
  • Fax:
Mailing address:
  • Phone: 208-207-9272
  • Fax: 208-980-7953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: ZACHARIAH J JENSEN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 208-207-9272