Provider Demographics
NPI:1255650891
Name:HENDERSON, CATHERINE A (PHD, ARNP)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 114TH AVE SE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6942
Mailing Address - Country:US
Mailing Address - Phone:425-454-3136
Mailing Address - Fax:425-451-2361
Practice Address - Street 1:1300 114TH AVE SE
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6942
Practice Address - Country:US
Practice Address - Phone:425-454-3136
Practice Address - Fax:425-451-2361
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600-363-180102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst