Most Relevant Information
Provider Data
| NPI Number: | 1003309089 |
| Provider Name: | LACI JENSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 61399348 |
Most Important Dates
| Enumeration Date: | 06/13/2018 |
| Last Updated: | 10/05/2023 |
Provider Practice Location
15446 BEL RED RD STE 401
REDMOND
WA
980525507
Practice Location Phone/Fax
| Phone: | 9718012054 |
| Fax: |
Provider Mailing Location
7530B 15TH AVE NW
SEATTLE
WA
981175453
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |