Provider Demographics
NPI:1356726053
Name:JENSEN, ALEX MATTHEW (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:MATTHEW
Last Name:JENSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 E 44TH AVE
Mailing Address - Street 2:APT K305
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7709
Mailing Address - Country:US
Mailing Address - Phone:509-290-3617
Mailing Address - Fax:
Practice Address - Street 1:5921 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-2484
Practice Address - Country:US
Practice Address - Phone:509-462-6576
Practice Address - Fax:509-434-1923
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60547199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist