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1972060978
BRAD LANCE JENSEN
CHEHALIS, WA
NPI
1972060978
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP60185873)
Enumeration Date
2019-02-26
Last Update Date
2019-02-26
Business Address
Mr. BRAD LANCE JENSEN CDP
500 SE WASHINGTON AVE
CHEHALIS, WA 98532-3058
Phone number: 360-748-4776
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Mailing Address
Mr. BRAD LANCE JENSEN CDP
500 SE WASHINGTON AVE
CHEHALIS, WA 98532-3058
Phone number: 360-748-4776
Copy
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