Jensen, Paul Scott

Jensen, Paul Scott is an sole proprietor health care provider with primary practice located at 112 Pelly Ave N , Renton WA 98057-5713. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jensen, Paul Scott can be contacted via phone (425) 255-2020.

Contact Information

Primary practice address
112 Pelly Ave N Renton WA 98057-5713
Fax: (425) 255-2028
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1722TX Washington

Profile Details

NPI number 1891792370
LBN Legal business name Jensen, Paul Scott
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2005
Last updated Jul 16th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891792370 NPPES
Washington MEDICAID 2061467

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