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NPI Profile for LARRY D JENSEN in TIGARD, OR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot |
213ES0131X | 48 | Podiatry |
| NPI Number | 1851383269 |
|
| Status | Active | |
| Credentials | DPM (Doctor of Podiatric Medicine) | |
| Entity | Individual | |
| Enumeration date | 08/22/2005 | |
| Last updated | 05/04/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LARRY D JENSEN
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LARRY D JENSEN, DPM