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General NPI Number Information
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NPI Number | 1225386659
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Entity Type | Individual
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Provider Name | DON C. H. HENKER O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 1333 SUPERIOR ST
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City | SANDPOINT
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State | ID
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Zip | 83864-1734
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Country | US
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Telephone | 208-265-4140
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Fax | 208-265-4448
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Provider Business Mailing Address
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Address Line | 1333 SUPERIOR ST
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City | SANDPOINT
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State | ID
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Zip | 83864-1734
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Country | US
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Telephone | 208-265-4140
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Fax | 208-265-4448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODP100252
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD 00003201
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License Number State | WA
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