NPI 1396040077

Shelly Marie Henderson, RMA

Practitioner Physical Disabilities Residential Treatment Facility Colbert, WA

Practice location

Address: 5612 E Cargill Ln, Colbert, WA 99005-9110
Phone: (509) 238-4171
Mailing address: 5021 E Cargill Ln, Colbert, WA 99005-9142

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 249694 (WA)

Other Residential Treatment Facility, Physical Disabilities providers in Washington →

Registry record

NPI: 1396040077
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Jan 2011
Record last updated: 11 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.