| NPI | 1619272119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE E JENSEN Provider/Owner 253-588-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30005224) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |