Individual
AMELIA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3944 87TH AVE SE, OLYMPIA, WA 98501-9516
(360) 413-7602
Mailing address
3944 87TH AVE SE, OLYMPIA, WA 98501-9516
(360) 413-7602
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
385000
WA
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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