Provider Demographics
NPI:1598104085
Name:YOUNG, AUBREY JENSEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:JENSEN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 W TAPPS DR E
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-9176
Mailing Address - Country:US
Mailing Address - Phone:253-862-8001
Mailing Address - Fax:
Practice Address - Street 1:3920 W TAPPS DR E
Practice Address - Street 2:
Practice Address - City:LAKE TAPPS
Practice Address - State:WA
Practice Address - Zip Code:98391-9176
Practice Address - Country:US
Practice Address - Phone:253-862-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60326904363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical