Individual
DR. GREGORY S HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
2520 CHERRY AVE, PATHOLOGY DEPARTMENT, BREMERTON, WA 98310-4229
(360) 792-6731
(360) 792-6561
Mailing address
PO BOX 2171, BREMERTON, WA 98310-0368
(360) 792-6731
(360) 792-6561
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD00048144
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1722111
—
LA
Enumeration date
05/05/2006
Last updated
07/08/2007
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