Individual
CHARLENA RAE NIEHENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 WILMINGTON DR STE 220, DUPONT, WA 98327-8773
(206) 453-4882
Mailing address
14719 E 16TH AVE, SPOKANE VALLEY, WA 99037-9641
(509) 868-7669
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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