Michael Lee Henderson Jr., PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

19639 Issued in WA

Practice address

221 W Heron St
Aberdeen, WA 98520

Phone

(360) 532-8743

Fax

(360) 538-0063

NPI assigned

Jan 30, 2006

Last updated

May 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safeway Inc

  dba Safeway Pharmacy #1546

  • Community/Retail Pharmacy
  • Aberdeen, WA
  • NPI 1699704619
  NPD (past)
• Safeway Inc

  dba Safeway Pharmacy #0209

  • Community/Retail Pharmacy
  • Queen Creek, AZ
  • NPI 1730040973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1033180914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 NORTH NINTH STREET",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985632100",
            "telephone_number": "360-249-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W HERON ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "360-532-8743",
            "fax_number": "360-538-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "19639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Elizabeth Heikel, OTR
• Alicia Henderson, PH.D., CCC-SLP
• Darcy L Henderson
• Debra Ashley Henderson, SUDPT
• Elizabeth J Henderson
• Ray David Henderson, PTA
• E. Lori Henkel, LMP
• Hensley Chiropractic Clinic , P.S.
• Bradley Alan Hensley, D.C.
• Annette Louise Heple

• Pharmacist in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.