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CONNIE E JENSEN, PLLC

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Company Details

Legal Name: CONNIE E JENSEN, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: September 21st 2009
Date of Dissolution: August 19th 2014
Expiration date: 30 Sep 2014
UBI Number: 602 956 169

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Registered Agent Information

Name Role Address
CONNIE E JENSEN Registered Agent 4102 RIDGE RD W, UNIVERSITY PLACE, WA, 98466, UNITED STATES

Key Officers & Management

Name Role Address
CONNIE JENSEN Governing Person 4102 RIDGE RD W, UNIVERSITY PLACE, WA, 98466, UNITED STATES

National Provider Identifier

NPI Number:
1619272119

Authorized Person:

Name:
CONNIE E JENSEN
Role:
PROVIDER/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2539846774
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