Henken, Dale Preston

Henken, Dale Preston is an sole proprietor health care provider with primary practice located at 1900 Woodland Dr , Coos Bay OR 97420-2045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Henken, Dale Preston can be contacted via phone (541) 267-5151.

Contact Information

Primary practice address
1900 Woodland Dr Coos Bay OR 97420-2045
Phone: (541) 267-5151
Fax: (541) 266-4562
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G41486 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD150386 Oregon

Profile Details

NPI number 1306097555
LBN Legal business name Henken, Dale Preston
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 7th, 2008
Last updated Sep 26th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306097555 NPPES
Oregon Other 93-0635514 NBMC MAIN GROUP TAX ID FOR BILLING
Oregon Other 161133 NBMC MAIN GROUP TAX ID FOR BILLING
Oregon MEDICAID 500630202 NBMC MAIN GROUP TAX ID FOR BILLING
Oregon Other MD150386 NBMC MAIN GROUP TAX ID FOR BILLING
Oregon Other 1407812365 NBMC MAIN GROUP TAX ID FOR BILLING
Oregon Other R0000WFBTV NBMC MAIN GROUP TAX ID FOR BILLING

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