Provider Demographics
NPI:1306103106
Name:OSTENSON, LENNA JEANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:LENNA
Middle Name:JEANNE
Last Name:OSTENSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 NE 30TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6834
Mailing Address - Country:US
Mailing Address - Phone:317-435-9580
Mailing Address - Fax:
Practice Address - Street 1:2702 NE 78TH ST STE 104
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-0664
Practice Address - Country:US
Practice Address - Phone:360-573-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602420411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice