Provider Demographics
NPI:1700229929
Name:HENDERSON, MONICA ZOLLNER (DNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ZOLLNER
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ARNEY RD STE 120
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-9472
Mailing Address - Country:US
Mailing Address - Phone:503-814-4400
Mailing Address - Fax:503-814-8659
Practice Address - Street 1:105 ARNEY RD STE 120
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9472
Practice Address - Country:US
Practice Address - Phone:503-814-4400
Practice Address - Fax:503-814-8659
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201505318NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily