Individual
WESLEY SCOTT HENRICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
971 11TH AVE, LONGVIEW, WA 98632-2503
(360) 577-1771
(360) 423-1405
Mailing address
971 11TH AVE, LONGVIEW, WA 98632-2503
(360) 577-1771
(360) 423-1405
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD60477315
WA
Other
Enumeration date
03/22/2011
Last updated
03/09/2017
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