Provider Demographics
NPI:1952714057
Name:JORGENSON, JANENE H (RN)
Entity Type:Individual
Prefix:
First Name:JANENE
Middle Name:H
Last Name:JORGENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 NORTH ST SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-3612
Mailing Address - Country:US
Mailing Address - Phone:360-596-7008
Mailing Address - Fax:360-596-7001
Practice Address - Street 1:1302 NORTH ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-3612
Practice Address - Country:US
Practice Address - Phone:360-596-7008
Practice Address - Fax:360-596-7001
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00095890163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse