Most Relevant Information
Provider Data
| NPI Number: | 1003468216 |
| Provider Name: | TABITHA ALANA JENSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/09/2019 |
| Last Updated: | 01/10/2020 |
Provider Practice Location
2595 CHRISTIE DRIVE
LAKE OSWEGO
OR
97034
Practice Location Phone/Fax
| Phone: | 5035173979 |
| Fax: |
Provider Mailing Location
1220 SW COLUMBIA ST
PORTLAND
OR
972013316
Provider Mailing Phone/Fax
| Phone: | 5035173979 |
| Fax: |