Individual
MRS. KATHLEEN R HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
6216 S 255TH ST APT DD202, KENT, WA 98032-4996
(253) 670-8884
Mailing address
6216 S 255TH ST APT DD202, KENT, WA 98032-4996
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA 60041777
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VA 60041777
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
10/24/2008
Last updated
10/24/2008
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