Individual
HENDRIKA MARIA NOUWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., C.M.T.
Contact information
Practice address
11990 SHENANDOAH RD, MIDDLETOWN, CA 95461-7708
(707) 772-7298
Mailing address
11990 SHENANDOAH RD, MIDDLETOWN, CA 95461-7708
(707) 772-7298
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
211536
CA
174400000X
Specialist
MA00005693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350041001
GROUP HEALTH PROVIDER ID
WA
01
—
78574
PROVIDER ID L & I
WA
01
—
NO 0704
REGENCE PROVIDER ID
WA
Enumeration date
03/02/2007
Last updated
11/18/2014
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