Individual
STEPHEN D HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00025264
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008874
—
WA
Enumeration date
08/03/2005
Last updated
10/31/2022
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