Active NPI
Gary Lee Henriksen, M.D.
- Occupational Medicine Physician
- Sequim, WA
National Provider Identifier
1033442298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- MD00014466
- Practice address
- 362 Greywolf Rd
Sequim, WA 98382-7574 - Phone
- (360) 683-7784
- NPI assigned
- Sep 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | MD00014466 | WA | |
| Occupational Medicine Physician | 2083X0100X | MD00014466 | WA | Primary |
Addresses
Primary practice location
362 Greywolf Rd
Sequim, WA 98382-7574
Mailing address
362 Greywolf Rd
Sequim, WA 98382-7574
Phone (360) 683-7784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00014466 | WA | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252022400000",
"number": "1033442298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "362 GREYWOLF RD",
"city": "SEQUIM",
"state": "WA",
"postal_code": "983827574",
"telephone_number": "360-683-7784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "362 GREYWOLF RD",
"city": "SEQUIM",
"state": "WA",
"postal_code": "983827574",
"telephone_number": "360-683-7784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIKSEN",
"first_name": "GARY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-04",
"last_updated": "2009-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "WA",
"license": "MD00014466",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "WA",
"license": "MD00014466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sequim, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.