National Provider Identifier Database

PHYLLIS J HENDERSON, MD – NPI #1487863999
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

PHYLLIS J HENDERSON, MD
402 S 4TH AVE
YAKIMA, WA98902-3546
Phone: 808-575-4084
Fax: 509-575-4234
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X
Psychiatry 2084P0800X

* Indicates primary specialty

NPI Profile & details for PHYLLIS J HENDERSON

NPI Number 1487863999
Credentials MD
Entity Individual
Enumeration date 05/21/2007
Last updated 01/04/2024 - About 2 years ago
Sole proprietor1 Yes
Identifiers
  • WA License #: 26126
  • WA License #: WA26126
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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