Healthcare Provider Details

I. General information

NPI: 1346158672
Provider Name (Legal Business Name): TESSA SHANAY JENSEN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19017 83RD AVE W
EDMONDS WA
98026-6018
US

IV. Provider business mailing address

19017 83RD AVE W
EDMONDS WA
98026-6018
US

V. Phone/Fax

Practice location:
  • Phone: 801-735-8170
  • Fax:
Mailing address:
  • Phone: 801-735-8170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.60455107
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: