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1154686830
WILLIE FAYE HENDERSON
SPRINGFIELD, OR
NPI
1154686830
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OR 6560)
Enumeration Date
2012-07-09
Last Update Date
2012-07-09
Business Address
-- WILLIE FAYE HENDERSON
2073 OLYMPIC ST SUITE 301
SPRINGFIELD, OR 97477-3413
Phone number: 541-682-3550
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Mailing Address
-- WILLIE FAYE HENDERSON
2073 OLYMPIC ST
SPRINGFIELD, OR 97477-3413
Phone number: 541-682-3550
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