Individual provider Active NPI

Jenifer Lee Henderson, M.D.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Silverdale, WA
National Provider Identifier
1366574501
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
MD00037936 Issued in WA
Practice address
2011 NW Myhre PL
Silverdale, WA 98383-8561
Phone
(360) 830-1755
Fax
(360) 830-1782
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X MD00037936 WA Primary

Addresses

Primary practice location

2011 NW Myhre PL
Silverdale, WA 98383-8561

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone (360) 830-1755

Other identifiers 3

IdentifierTypeStateIssuer
8252181MedicaidWA
8918HEOtherREGENCE
242391OtherWALABOR & INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090206000345 WA Practitioner - Plastic and Reconstructive Surgery 1456416452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2011 NW Myhre PL
Silverdale, WA 98383-8561
Phone (360) 830-1600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00037936WAMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

450 S Kitsap Blvd
Ste 250
Port Orchard, WA 98366
Phone (360) 782-3000

19245 7th Ave NE
#O
Poulsbo, WA 98370
Phone (360) 782-3500

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

2011 NW Myhre Pl
Silverdale, WA 98383
Phone (360) 830-1600

9398 Ridgetop Blvd NW
#O
Silverdale, WA 98383
Phone (360) 782-3200

2200 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 830-1100

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: jenifer.henderson@tdc.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366574501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502",
            "telephone_number": "360-830-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 NW MYHRE PL",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838561",
            "telephone_number": "360-830-1755",
            "fax_number": "360-830-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JENIFER",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2023-03-07",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "WA",
            "license": "MD00037936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8252181",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "8918HE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "242391",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.