Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | AP60405017 | WA |
NPI | 1972939114 |
---|---|
Provider Name | Donna Lee Henry |
First Address | Spokane, WA 99202-4932 |
Second Address | Deer Park, WA 99006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2013 |
Last Update Date | 26/10/2021 |