Individual
DIANE M HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,CNOR,CRNFA
Contact information
Practice address
3816 48TH AVE NE, TACOMA, WA 98422-2472
(253) 925-5194
Mailing address
PO BOX 3544, FEDERAL WAY, WA 98063-3544
(253) 925-5194
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
025801RN00071286
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004332558
AETNA
—
01
—
0102455
L&I
WA
01
—
158254100000
BLUE CROSS
—
Enumeration date
01/28/2007
Last updated
07/08/2007
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