Provider Demographics
NPI:1932337946
Name:BAGGESEN-JENSEN, BEAUX (PMHNP-BC, ARNP, MSW)
Entity Type:Individual
Prefix:
First Name:BEAUX
Middle Name:
Last Name:BAGGESEN-JENSEN
Suffix:
Gender:F
Credentials:PMHNP-BC, ARNP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 NE 82ND AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6841
Mailing Address - Country:US
Mailing Address - Phone:866-657-6592
Mailing Address - Fax:619-383-6701
Practice Address - Street 1:5109 NE 82ND AVE STE 215
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6841
Practice Address - Country:US
Practice Address - Phone:866-657-6592
Practice Address - Fax:619-383-6701
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60763388363LP0808X
CA95004751363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health