Provider Demographics
NPI:1780802009
Name:HENRY, DONNA KAY (BS)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:KAY
Last Name:HENRY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 CONIFER PL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97114-9634
Mailing Address - Country:US
Mailing Address - Phone:503-864-2884
Mailing Address - Fax:
Practice Address - Street 1:182 SW ACADEMY ST
Practice Address - Street 2:SUITE 304
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1922
Practice Address - Country:US
Practice Address - Phone:503-623-9289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker