Provider Demographics
NPI:1396946497
Name:HENKE, SHERRIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:
Last Name:HENKE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15509 130TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-9613
Mailing Address - Country:US
Mailing Address - Phone:253-840-5712
Mailing Address - Fax:
Practice Address - Street 1:1201 VALLEY AVE E
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-3225
Practice Address - Country:US
Practice Address - Phone:253-826-8433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00020361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist