Necola Henderson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

11-CRM-118 Issued in OR

Practice address

3311 NE Martin Luther King Jr Blvd
Portland, OR 97212-2086

Phone

(503) 676-3710

NPI assigned

Nov 26, 2016

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1480118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480118400000",
    "number": "1801339734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122086",
            "telephone_number": "503-676-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122086",
            "telephone_number": "503-676-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "NECOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-26",
        "last_updated": "2016-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "11-CRM-118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Henderson, MD
• Jenne Henderson, PHD
• Jesse Remer Henderson, BCD, PCD, LCCE
• Jimi M Henderson
• Julia Henderson, LMT
• Patricia Leigh Henderson, PA-C
• Rebecca Alice Henderson
• Sydney Suzanne Henderson
• Tawny Henderson
• Colleen Elizabeth Hendery, MSW

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2016; 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.