Provider Demographics
NPI:1316546542
Name:JENSEN, BRITTNIE NICHOLE
Entity Type:Individual
Prefix:
First Name:BRITTNIE
Middle Name:NICHOLE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 126TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-2916
Mailing Address - Country:US
Mailing Address - Phone:682-333-1266
Mailing Address - Fax:
Practice Address - Street 1:821 126TH STREET CT E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-2916
Practice Address - Country:US
Practice Address - Phone:682-333-1266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician