Individual
LACEY DAWN HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
700 SE 160TH AVE STE 121, VANCOUVER, WA 98684-8910
(360) 253-3480
Mailing address
146 SYLVAN WAY, LONGVIEW, WA 98632-9628
(360) 747-0177
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH61571364
WA
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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