Destrey D. Hendricks, LMP
Specialist in Arlington, WA. Individual provider (NPI-1).
NPI number1861691677
StatusActive
Last updated in NPPESOct 14, 2009
Details
- NPI
- 1861691677
- Entity type
- Individual (NPI-1)
- Name
- Mr. Destrey D. Hendricks
- Credential
- LMP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 12, 2007
- Last updated
- Oct 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | MA00019094 | WA | Yes |
Practice location
3719 168th St NeUnit C
Arlington, WA 98223-8499
Phone 425-501-6545
Mailing address
3719 168th St NeUnit C
Arlington, WA 98223-8499
Phone 425-501-6545
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