Provider Demographics
NPI:1013329549
Name:JENSEN, MARY ALLISON (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY ALLISON
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARY ALLISON
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:4660 N VASSAULT ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-1228
Mailing Address - Country:US
Mailing Address - Phone:360-265-2037
Mailing Address - Fax:
Practice Address - Street 1:4660 N VASSAULT ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-1228
Practice Address - Country:US
Practice Address - Phone:360-265-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605128901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical