SHELLY MARIE HENDERSON (NPI# 1396040077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396040077 |
Entity Type | Individual |
Full Name | SHELLY MARIE HENDERSON |
Credential | RMA |
Practice Address |
5612 E Cargill Ln Colbert WA 99005-9110 |
Mailing Address |
5021 E Cargill Ln Colbert WA 99005-9142 |
Practice Telephone | 5092384171 |
Mailing Telephone | 5092384171 |
Enumeration Date | 2011-01-11 |
Last Update Date | 2011-01-11 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320700000X | Residential Treatment Facility, Physical Disabilities | 249694 | WA | Residential Treatment Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205097011 | Shelly Lee Henderson | Psychologist | 4860 Y St Ste 2300, Sacramento, CA 95817-2307 | 2008-06-24 |
1184071722 | Shelly Lynn Henderson | Massage Therapist | 10001 Se Sunnyside Rd, Clackamas, OR 97015-5746 | 2016-05-23 |
1558631184 | Shelly Annette Henderson | Counselor | 1604 N Washington Ave, Durant, OK 74701-2128 | 2012-01-12 |
Street Address |
5612 E CARGILL LN |
City | COLBERT |
State | WA |
Zip Code | 99005-9110 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811298227 | Stephanie Huntley | Occupational Therapist | 16306 N Chronicle Ln, Colbert, WA 99005-4502 | 2010-11-16 |
1184922809 | Kinetic Orthopedics | Durable Medical Equipment & Medical Supplies | 17120 N Dakota Ln, Colbert, WA 99005-5015 | 2011-03-03 |
1538246152 | Debra Jean Ravasia | Obstetrics & Gynecology | 16809 N Cincinnati Ln, Colbert, WA 99005-5107 | 2006-11-01 |
1639292790 | John David Johnson IIi | Audiologist | 21626 N Hille Ln, Colbert, WA 99005-8304 | 2007-04-06 |
1174045421 | Kim Sain | Psychologist | 18024 N Addison Ct, Colbert, WA 99005-8524 | 2017-07-07 |
1265854384 | Deborah Joy Bone | Occupational Therapist | 2105 E Half Moon Lake Ln, Colbert, WA 99005-9154 | 2014-01-08 |
1750718268 | Kevin G Sant | Pharmacist | 21417 Buckeye Lake Ln, Colbert, WA 99005-9191 | 2013-09-28 |
1235695453 | Deborah Kaye Hunt | Custodial Care Facility | 227 E Midway Rd, Colbert, WA 99005-9206 | 2019-02-12 |
1538495320 | Brandy Bergeson | Specialist | 18107 N Palomino Rd, Colbert, WA 99005-9316 | 2009-10-29 |
1790185791 | Spokane International Academy | Local Education Agency (LEA) | 18020 N Redowa Dr, Colbert, WA 99005-9342 | 2014-08-26 |
Find all providers in zip 99005 |
Taxonomy Code | 320700000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Physical Disabilities |
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003362328 | Vladimir Kuksenko | Residential Treatment Facility, Physical Disabilities | 1958 Eaton Ave, Ferndale, WA 98248-9709 | 2016-08-28 |
1740642875 | Dee Mcgonigle | Residential Treatment Facility, Physical Disabilities | 4545 Sand Point Way Ne, 608, Seattle, WA 98105-3926 | 2016-03-28 |
1376916841 | Todd Medical Foundation | Residential Treatment Facility, Physical Disabilities | 38426 Se 45th Pl, Snoqualmie, WA 98065-9101 | 2015-11-05 |
1639587306 | Heal Your World Massage Therapy | Residential Treatment Facility, Physical Disabilities | 2038 Mccloud Creek Rd, Newport, WA 99156-8797 | 2014-07-25 |
1578805800 | Ronald Linn Burgner | Residential Treatment Facility, Physical Disabilities | 26221 5th Ave Ne, Arlington, WA 98223-7662 | 2013-03-25 |
1699922179 | Annette Hobbs, Inc. | Residential Treatment Facility, Physical Disabilities | 2000 W Barrett St, 201, Seattle, WA 98199-2969 | 2008-08-26 |
1609036714 | Best Quality Home Care, LLC | Residential Treatment Facility, Physical Disabilities | 317 S Berry St, Centralia, WA 98531-4103 | 2008-06-12 |
1992136980 | Jessie Anna Finn | Residential Treatment Facility, Physical Disabilities | 6021 N Lidgerwood St, Spokane, WA 99208-1125 | 2013-12-02 |
Please comment or provide details below to improve the information on SHELLY MARIE HENDERSON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.