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NPI Code Detail

MEDICARE: MR. ZACHARIAH JON JENSEN DO

MEDICARE: MR. ZACHARIAH JON JENSEN DO
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
1204D00000XNeuromusculoskeletal Medicine & OMM Physician0102205792VA
2208100000XPhysical Medicine & Rehabilitation PhysicianO-1779ID
3174400000XSpecialist12884SD
4204D00000XNeuromusculoskeletal Medicine & OMM Physician12884SD

General Provider Information

NPI Number : 1184128175
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ZACHARIAH JON JENSEN DO
Provider Business Mailing Address
First Line : PO BOX 8111
Second Line :
City : BOISE
State : ID
Zip : 83707-2111
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 711 N CURTIS RD
Second Line :
City : BOISE
State : ID
Zip : 83706-1445
Country : US
Telephone Number : 208-605-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 01/02/2026

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