Individual
DONNA CATE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1101 N. HIGHWAY 197, MAUPIN, OR 97037-9703
(503) 510-3789
(866) 490-5249
Mailing address
PO BOX 372, MAUPIN, OR 97037-0372
(503) 510-3789
(866) 490-5249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0995
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082565000
REGENCE BCBSO PROVIDER #
OR
01
—
267590
VALUE OPTIONS PROVIDER #
VA
Enumeration date
12/27/2006
Last updated
11/27/2019
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