Provider Information for 1669707345
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Ms. JACQUELINE GABRIELE JENSEN LPC
Sex: Female
NPI: 1669707345
Last Updated: 2024-08-16
Certification Date: 2024-08-16
Certification Date: 2024-08-16
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669707345 | ||||||||
| Enumeration Date | 2009-10-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2740 SE POWELL BLVD STE 6 PORTLAND, OR 97202-2069 United States Phone: 971-271-4237 | Fax: | ||||||||
| Primary Practice Address | 2740 SE POWELL BLVD STE 6 PORTLAND, OR 97202-2069 United States Phone: 971-271-4237 | Fax: | ||||||||
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