Doctor Name: | ERIC HOUGAARD JENSEN |
NPI Number: | 1861578049 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD00008566 |
Business Practice Address: | 1306 N 175th St Ste 11 Shoreline, WA - 98133 |
Business Phone Number: | 2065422149 |
Business Fax Number: | 2065424802 |
Mailing Address: | 1306 N 175th St, Ste 11 SHORELINE |
State: | WA |
Postal Code: | 98133 |
Phone Number: | 2065422149 |
Fax Number: | 2065424802 |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD00008566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |