MEDICARE: KRISTEN JANEL ENSEY

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
1	237700000X	Hearing Instrument Specialist	HA61016756	WA

General Provider Information

NPI Number	:	1326645003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN JANEL ENSEY

Provider Business Mailing Address
First Line	:	1311 S UNION AVE STE 102
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-1959
Country	:	US
Telephone Number	:	253-759-3555
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 100TH PL SE STE A
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98208-3868
Country	:	US
Telephone Number	:	425-337-9109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	10/06/2020

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Directions to “ KRISTEN JANEL ENSEY ” Practice Location

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