Provider Demographics
NPI:1588793244
Name:JENSEN, JANET (PT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 COLCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-4020
Mailing Address - Country:US
Mailing Address - Phone:301-897-5655
Mailing Address - Fax:301-897-8835
Practice Address - Street 1:5411 W CEDAR LN
Practice Address - Street 2:209-A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1516
Practice Address - Country:US
Practice Address - Phone:301-897-5655
Practice Address - Fax:301-897-8835
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG00624Medicare ID - Type UnspecifiedGROUP NUMBER
MD00A698J24Medicare ID - Type Unspecified