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Individual
SUSAN MARIE HENDERSON
Active
Individual
SUSAN MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60472039
WA
363L00000X
Nurse Practitioner
Primary
AP61185728
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649835257
—
WA
Enumeration date
05/08/2019
Last updated
01/18/2022
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