Provider Demographics
NPI:1841775715
Name:JENSEN, RACHEL (LAC, DIPL AC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 HAMLINE AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-2109
Mailing Address - Country:US
Mailing Address - Phone:651-373-2815
Mailing Address - Fax:
Practice Address - Street 1:1032 GRAND AVE STE 201
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3064
Practice Address - Country:US
Practice Address - Phone:651-560-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1881171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist