Individual
EDWARD ALAN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
60083599
WA
Other
Enumeration date
11/25/2009
Last updated
11/25/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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