Individual
MRS. KATHLEEN CHRISTINE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
411 FORTUYN RD, GRAND COULEE, WA 99133-8718
(509) 633-1911
(509) 633-1933
Mailing address
411 FORTUYN RD, GRAND COULEE, WA 99133-8718
(509) 633-1911
(509) 633-1933
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61036303
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0423364
LNI
WA
05
—
2155854
—
WA
Enumeration date
11/10/2015
Last updated
06/23/2020
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