Healthcare Provider Details

I. General information

NPI: 1740239904
Provider Name (Legal Business Name): BSHARON C JENSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: B SHARON COLE M.D.

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 13TH ST STE 200
EVERETT WA
98201-1621
US

IV. Provider business mailing address

PO BOX 84642
SEATTLE WA
98124-5942
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5597
  • Fax: 425-297-5598
Mailing address:
  • Phone: 425-297-5590
  • Fax: 425-297-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: