Individual
APRIL NICOLE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 NW LOST SPRINGS TER STE 305, PORTLAND, OR 97229-6656
(502) 817-8770
Mailing address
520 NW LOST SPRINGS TER STE 305, PORTLAND, OR 97229-6656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62407
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W59644444
MODA
OR
Enumeration date
12/03/2018
Last updated
12/03/2018
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