Provider Demographics
NPI:1750899514
Name:UHDER, JENS (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENS
Middle Name:
Last Name:UHDER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 S VALLEY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:VALLEYFORD
Mailing Address - State:WA
Mailing Address - Zip Code:99036-5012
Mailing Address - Country:US
Mailing Address - Phone:509-730-2211
Mailing Address - Fax:509-730-2212
Practice Address - Street 1:707 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2832
Practice Address - Country:US
Practice Address - Phone:509-730-2211
Practice Address - Fax:509-730-2212
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60797048103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical