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NPI Code Detail

MEDICARE: DAYLE FERN HENDERSON

MEDICARE: DAYLE FERN HENDERSON
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
1390200000XStudent in an Organized Health Care Education/Training Program1326482563OR

General Provider Information

NPI Number : 1760321129
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAYLE FERN HENDERSON
Provider Business Mailing Address
First Line : 4950 NE BELKNAP CT STE 205
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-5115
Country : US
Telephone Number : 503-560-5822
Fax Number : 888-503-2864
Provider Business Practice Location Address
First Line : 4950 NE BELKNAP CT STE 205
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-5115
Country : US
Telephone Number : 503-560-5822
Fax Number : 888-503-2864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2026
Last Update Date : 03/27/2026

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Directions to “ DAYLE FERN HENDERSON ” Practice Location

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