Individual
MARK HENNECKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
7224 PACIFIC HWY E., MILTON, WA 98354
(253) 220-6183
Mailing address
8117 70TH AVE SW, LAKEWOOD, WA 98499-2009
(720) 339-3306
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60984646
WA
Other
Enumeration date
12/26/2019
Last updated
09/19/2024
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