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NPI Code Detail

MEDICARE: SIQUOY HENDERSON-JOHNSON

MEDICARE:   SIQUOY  HENDERSON-JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1134088057
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIQUOY HENDERSON-JOHNSON
Provider Business Mailing Address
First Line : 3111 BROAD ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-8342
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3111 BROAD ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-8342
Country : US
Telephone Number : 206-637-7035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “ SIQUOY HENDERSON-JOHNSON ” Practice Location

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