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Individual

HENEDINE CLARK HERNANDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1901 S UNION AVE, A221, TACOMA, WA 98405-1702
(253) 459-6231
(253) 459-6858
Mailing address
1608 S J ST FL 4, TACOMA, WA 98405-4930
(253) 207-4200
(253) 207-4285

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60212754
WA
363LA2200X
Adult Health Nurse Practitioner
AP60212754
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60212754
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2012633
WA
Enumeration date
12/06/2007
Last updated
11/02/2023
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