Provider Demographics
NPI:1407297955
Name:HENDSCH, MONICA B (HIS)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:B
Last Name:HENDSCH
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 GEORGIANA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3511
Mailing Address - Country:US
Mailing Address - Phone:360-452-2228
Mailing Address - Fax:360-457-9666
Practice Address - Street 1:819 GEORGIANA ST
Practice Address - Street 2:SUITE B
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3511
Practice Address - Country:US
Practice Address - Phone:360-452-2228
Practice Address - Fax:360-457-9666
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA 60282057237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist