Individual
MAXWELL HAROLD HENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 753-4912
Mailing address
3022 NE 58TH AVE, PORTLAND, OR 97213-3356
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10008115
OR
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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