Provider Type Icon

DR. PHYLLIS JO HENDERSON MD NPI 1487863999


NPI Information

NPI: 1487863999
Provider Name: DR. PHYLLIS JO HENDERSON, MD
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Individual

Specialization: Addiction Medicine

Organization: COMPREHENSIVE HEALTHCARE

PECOS Registration: Yes

Address:
418 S 44TH AVE
YAKIMA, WA
ZIP 98908
Phone: (509) 249-0105
Get Directions

DR. Phyllis Jo Henderson, MD is an addiction medicine psychiatry neurology in Yakima, WA with 36 years of experience. The provider is 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 DR. Phyllis Jo Henderson, MD NPI is 1487863999. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1988

The provider's business location address is:

418 S 44TH AVE
YAKIMA, WA
ZIP 98908-303
Phone: (509) 249-0105
Fax: (509) 249-0035

The NPI 1487863999 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/21/2007 and was last updated on 3/12/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084A0401XPsychiatry & NeurologyAddiction Medicine26126WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G18806143MEDICARE PINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.