Individual
SUSAN MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1221 MADISON ST, 2ND FL, SEATTLE, WA 98104-3588
(206) 386-2323
(206) 215-6165
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60472039
WA
363L00000X
Nurse Practitioner
Primary
AP61185728
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649835257
—
WA
Enumeration date
05/08/2019
Last updated
01/18/2022
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