Basic Information
| Provider Information | |||||||||
| NPI: | 1477507929 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HENKLE | ||||||||
| FirstName: | ESTHER | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CAVERO-JIMENEZ | ||||||||
| OtherFirstName: | ESTHER | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 34936 | ||||||||
| Address2: | DEPT. #5006 PO BOX 34936 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981241936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064392988 | ||||||||
| FaxNumber: | 2064313939 | ||||||||
| Practice Location | |||||||||
| Address1: | 22000 MARINE VIEW DR S | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981986233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068704460 | ||||||||
| FaxNumber: | 2068704770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD00042656 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.