Individual
HEATHER HENNESSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
727 N TOWER AVE, CENTRALIA, WA 98531-4754
(360) 827-0264
Mailing address
PO BOX 144, CENTRALIA, WA 98531-0144
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
00064301
WA
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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