Individual
MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12495 SW 112TH AVE, TIGARD, OR 97223-4002
(971) 645-3612
Mailing address
12495 SW 112TH AVE, TIGARD, OR 97223-4002
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/29/2019
Last updated
09/29/2019
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