Individual
IAN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 NE COUCH ST, PORTLAND, OR 97232-2922
(503) 233-6090
Mailing address
3812 N BORTHWICK AVE, PORTLAND, OR 97227-1222
(317) 650-3096
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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