Stacy C Henderson, ARNP, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61191864 Issued in WA

Practice address

1600 7TH Ave Ste 110
Seattle, WA 98101-2288

Phone

(888) 663-6331

Fax

(415) 252-7176

NPI assigned

Sep 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
• Direct secure messaging: shenderson84982@direct.tecmc.com

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.

• The Polyclinic PLLC

  • Audiologist
  • Seattle, WA
  • NPI 1174594634

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766

  Family Medicine

  Medicare reassignment NPD
• One Medical Group, Inc.

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1023899978
  Medicare reassignment
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425

  Family Medicine

  NPD
• Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Arlington, WA
  • NPI 1366154304
  NPD
• The Polyclinic

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1073944039
  NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487

  Family Medicine

  NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Seattle, WA
  • NPI 1346620200

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1631318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1730858879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE STE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012288",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4540 Union Bay Pl NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981054025",
            "country_code": "US",
            "telephone_number": "206-320-3400",
            "fax_number": "206-320-5773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "STACY",
        "middle_name": "C",
        "credential": "ARNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-11",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61191864",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60434895",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61191864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730858879",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy M. Henderson, MSW
• Rachel Marie Henderson, MD
• Ryan Henderson, PH.D.
• Sarah Ellen Henderson, MED, LMHCA
• Sherry Marie Henderson, MSW
• Susan Marie Henderson, ARNP
• Tracy Henderson, LMHC
• William R Henderson Jr.
• Marshall Hendlin
• Lori Luan Hendon

• Family Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.