Healthcare Provider Details

I. General information

NPI: 1891898458
Provider Name (Legal Business Name): CAROLYN HENDRIKSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 N JEFFERSON LN STE 200
SPOKANE WA
99201-7104
US

IV. Provider business mailing address

546 N JEFFERSON LN STE 200
SPOKANE WA
99201-7104
US

V. Phone/Fax

Practice location:
  • Phone: 509-625-3700
  • Fax: 509-625-3747
Mailing address:
  • Phone: 509-625-3700
  • Fax: 509-625-3747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30004760
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: