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Individual

EDWARD ALAN HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
33020 16TH PL SW, FEDERAL WAY, WA 98023-6461
(253) 250-5903
Mailing address
33020 16TH PL SW, FEDERAL WAY, WA 98023-6461
(253) 250-5903

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
60083599
WA

Other

Enumeration date
11/25/2009
Last updated
11/25/2009
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