Jerry Lynn Henderson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00002471 Issued in WA

Practice address

17644 140TH Ave NE
Woodinville, WA 98072-6800

Phone

(425) 402-9772

Fax

(425) 402-9443

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861414948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17644 140TH AVE NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726800",
            "telephone_number": "425-402-9772",
            "fax_number": "425-402-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17644 140TH AVE NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726800",
            "telephone_number": "425-402-9772",
            "fax_number": "425-402-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JERRY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PIN#",
            "identifier": "19038",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7114150",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I GROUP #",
            "identifier": "0160454",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8323677",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heath Family Counseling PLLC
• Catherine Jean Heath, LMFTA
• Julianne M Hegeman, OTR
• Hailey Heishman, ND
• Tracy Lynn Hendershott, PT
• Kyle Joseph Henneberry, MD
• Daniel Henriquez, RN
• Minerva Henson, L. AC., EAMP
• Cheryl Jean Herrin-Michehl, LMHC
• David Martin Hester Jr., LMHC, MHP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.