Provider Demographics
NPI:1770774150
Name:STENTZ, JENNIFER RENEE (LMP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:STENTZ
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SPOKANE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6132
Mailing Address - Country:US
Mailing Address - Phone:509-888-3898
Mailing Address - Fax:509-888-8001
Practice Address - Street 1:11 SPOKANE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6132
Practice Address - Country:US
Practice Address - Phone:509-888-3898
Practice Address - Fax:509-888-8001
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024443174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist