Organization
PHILIP H. HENDERSON III
Active
Other names
Philip H. Henderson III, M.D., P.S.
Organization subpart
No
Provider details
NPI number
Authorized official
STELLA KENDALL (BILLING OFFICE COORDINATOR)
(360) 423-2450
Entity
Organization
Contact information
Practice address
790 14TH AVE, LONGVIEW, WA 98632-2315
(360) 423-2450
(360) 425-4969
Mailing address
790 14TH AVE, LONGVIEW, WA 98632-2315
(360) 423-2450
(360) 425-4969
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00018570
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1662907
—
WA
01
—
AB33113
MEDICARE GROUP PIN
WA
Enumeration date
05/13/2008
Last updated
05/13/2008
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