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NPI Code Detail

MEDICARE: DR. JENNIFER HELENE SANSEN DC

MEDICARE:  DR. JENNIFER HELENE SANSEN  DC
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
1111N00000XChiropractor3048WA

General Provider Information

NPI Number : 1265424220
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER HELENE SANSEN DC
Provider Business Mailing Address
First Line : 200 BETHEL AVE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-5216
Country : US
Telephone Number : 360-876-4171
Fax Number : 360-876-3495
Provider Business Practice Location Address
First Line : 200 BETHEL AVE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-5216
Country : US
Telephone Number : 360-876-4171
Fax Number : 360-876-3495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 06/05/2012

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Directions to “ DR. JENNIFER HELENE SANSEN DC” Practice Location

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