Provider Demographics
NPI:1477507929
Name:HENKLE, ESTHER (MD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:HENKLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:CAVERO-JIMENEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34936
Mailing Address - Street 2:DEPT. #5006 PO BOX 34936
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1936
Mailing Address - Country:US
Mailing Address - Phone:206-439-2988
Mailing Address - Fax:206-431-3939
Practice Address - Street 1:22000 MARINE VIEW DR S
Practice Address - Street 2:SUITE 100
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6233
Practice Address - Country:US
Practice Address - Phone:206-870-4460
Practice Address - Fax:206-870-4770
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042656207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAI29509Medicare UPIN