Individual
SUSANNE NOEL HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1802 YAKIMA AVE STE 302, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-6576
Mailing address
1802 YAKIMA AVE STE 302, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-6576
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP61159008
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
AP61159008
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217925
—
WA
Enumeration date
06/22/2021
Last updated
09/16/2021
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