Provider Demographics
NPI:1790834786
Name:JENSEN, CYNTHIA JEAN (MSW, MHP, CDP, RC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JEAN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MSW, MHP, CDP, RC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-0502
Mailing Address - Fax:
Practice Address - Street 1:1813 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-4600
Practice Address - Country:US
Practice Address - Phone:360-538-1461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00018963101YP2500X
WALW00009467104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional