Healthcare Provider Details

I. General information

NPI: 1144215567
Provider Name (Legal Business Name): KATHLEEN JO HENSCH-FLEMING C.N.M., A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 01/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 NE 139TH ST SUITE 255
VANCOUVER WA
98686-2309
US

IV. Provider business mailing address

2101 NE 139TH ST SUITE 255
VANCOUVER WA
98686-2309
US

V. Phone/Fax

Practice location:
  • Phone: 360-885-7926
  • Fax: 360-802-0208
Mailing address:
  • Phone: 360-885-7926
  • Fax: 360-802-0208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP30003236
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: