Provider Demographics
NPI:1134768682
Name:HENSLEY, CHARRI MICHELE
Entity type:Individual
Prefix:
First Name:CHARRI
Middle Name:MICHELE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4232
Mailing Address - Country:US
Mailing Address - Phone:425-760-2372
Mailing Address - Fax:360-363-4168
Practice Address - Street 1:1085 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4232
Practice Address - Country:US
Practice Address - Phone:425-760-2372
Practice Address - Fax:360-363-4168
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other