Dr John R Henry, DO | |
850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800 | |
(509) 565-4000 | |
(509) 565-4705 |
Full Name | Dr John R Henry |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 850 Maple Street, Medical Lake, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437131372 | NPI | - | NPPES |
8281222 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | OP00001700 (Washington) | Primary |
Entity Name | Department Of Social Dept Of Shs Div Of Instns |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467440602 PECOS PAC ID: 9133013725 Enrollment ID: O20040213000028 |
Mailing Address | Practice Location Address |
---|---|
Dr John R Henry, DO Po Box 800, Eastern State Hospital, Medical Lake, WA 99022-0800 Ph: (509) 565-4000 | Dr John R Henry, DO 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800 Ph: (509) 565-4000 |
Laura J. Baehner, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705 | |
Dr. Samaya Cassandra Lovegood, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705 | |
Dr. Averly H Nelson, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705 | |
Dr. Evangeline V Dacanay, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 800 West Maple Street, Medical Lake, WA 99022 Phone: 509-299-3121 Fax: 509-299-7015 | |
Dr. Muneeb Malik, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 850 W Maple St, Medical Lake, WA 99022 Phone: 509-565-4000 | |
Dr. Lesley M. Blake, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-299-3121 Fax: 509-299-7015 | |
Marion Arthur Fossum, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1717 S Ritchey Rd, Medical Lake, WA 99022 Phone: 509-590-8766 |