Provider Demographics
NPI:1700911518
Name:JENSEN, JOSEPH LEHIGH III (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEHIGH
Last Name:JENSEN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1340
Mailing Address - Street 2:
Mailing Address - City:OKANOGAN
Mailing Address - State:WA
Mailing Address - Zip Code:98840-1340
Mailing Address - Country:US
Mailing Address - Phone:509-422-5700
Mailing Address - Fax:509-422-7680
Practice Address - Street 1:541 SECOND AVE
Practice Address - Street 2:
Practice Address - City:TWISP
Practice Address - State:WA
Practice Address - Zip Code:98856-9863
Practice Address - Country:US
Practice Address - Phone:509-997-2011
Practice Address - Fax:509-997-2034
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013844207Q00000X
OH35.033677207Q00000X
IDM-50858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1081470Medicaid
WA41233OtherLABOR AND INDUSTRY
WA1081470Medicaid
WA1081470Medicaid