Provider Demographics
NPI:1952667875
Name:HENKER, WHITNEY CAMILLE (OD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:CAMILLE
Last Name:HENKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1734
Mailing Address - Country:US
Mailing Address - Phone:208-265-4140
Mailing Address - Fax:
Practice Address - Street 1:1333 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1734
Practice Address - Country:US
Practice Address - Phone:208-265-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP100005152W00000X
WAOD 3200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist