Individual
JACOB D HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
21525 HWY 410 E STE B, BONNEY LAKE, WA 98391-4101
(253) 826-8520
Mailing address
301 S 320TH ST, FEDERAL WAY, WA 98003-5200
(877) 751-2446
(866) 559-3952
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61095770
WA
Other
Enumeration date
09/16/2020
Last updated
09/10/2025
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