Brenda Wagner Henoch, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00006557 Issued in WA

Practice address

1000 McKenzie Ave Ste 15
Bellingham, WA 98225-7003

Phone

(360) 752-2673

NPI assigned

Oct 26, 2007

Sex

Female

Sole proprietor

No

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)

Enrolled

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 and National Provider Directory roles.

• Core Performance LLC

  • Physical Therapist
  • Bellingham, WA
  • NPI 1003986233
  NPD (past)

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1205015203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MCKENZIE AVE STE 15",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257003",
            "telephone_number": "360-752-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MCKENZIE AVE STE 15",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257003",
            "telephone_number": "360-752-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENOCH",
        "first_name": "BRENDA",
        "middle_name": "WAGNER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellie Rose Hendrickson, RN
• Kristy Lynn Hendrickson
• Taylor Hendrickson
• Laurel Rose Henke, LMP
• Brian Henley
• Wade H Henrichs, MD
• Henry S. Levine, M.D.
• Jonathan J Henry, DMD
• Macon Fuliar Henry, APRN
• Sarah Jae Henry

• Physical Therapist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.