HENDERSON WIJAYA (NPI# 1326418823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326418823 |
| Entity Type | Individual |
| Full Name | HENDERSON WIJAYA |
| Practice Address |
Madigan Army Medical Ctr 9040 Reid Street Attn: Mchj-clq-c Tacoma WA 98431-1100 |
| Practice Telephone | 2539682252 |
| Practice Fax Number | 2539683278 |
| Mailing Telephone | 2539682252 |
| Mailing Fax Number | 2539683278 |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2015-09-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
MADIGAN ARMY MEDICAL CTR 9040 REID STREET ATTN: MCHJ-CLQ-C |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114954 | Larry E Witham | Physician Assistant | Madigan Army Medical Ctr, 9040a Reid Street, Tacoma, WA 98431-1100 | 2005-06-16 |
| 1417483512 | Carah Labrier | Emergency Medical Technician, Basic | Madigan Army Medical Ctr, 9040 Jackson Aveunue, Tacoma, WA 98431-0001 | 2017-05-10 |
| 1396270823 | Cherise Janen Hartman | Pharmacy Technician | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-04-21 |
| 1356876924 | Joseph Durso | Student in an Organized Health Care Education/Training Program | Madigan Army Medical Ctr, 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2017-04-20 |
| 1891228474 | Alfonso David Bernal-stevens | Emergency Medical Technician, Basic | Madigan Army Medical Ctr, 9040 Jackson Ave, Attn Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-04-10 |
| 1730612573 | Tifani Mcgovern | Registered Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-0001 | 2017-04-08 |
| 1770024184 | Susan Marie Beale | Licensed Practical Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-17 |
| 1417498957 | Danielle Jones | Pharmacy Technician | Madigan Army Medical Ctr, 9040 Jackson Ave. Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-16 |
| 1962943514 | Edwin Pampo | Registered Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-15 |
| 1497296578 | Margie Ayala | Technician, Pathology | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023560398 | Shilah Nickerson | Technician, Other | 1402 N Fife St, Tacoma, WA 98406-7405 | 2016-11-02 |
| 1902359946 | Rogers Joseph Greene Jr. | Technician, Other | 2215 63rd Ave Ne, Tacoma, WA 98422-3300 | 2016-07-26 |
| 1306297239 | Marie Quantrille | Technician, Other | 6212 S Mullen St, Tacoma, WA 98409-1234 | 2016-06-22 |
| 1023504594 | Austin J Cook | Technician, Other | 4301 S Pine St Ste 505, Tacoma, WA 98409-7208 | 2018-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1376012351 | Jennifer D English | Technician, Other | 9208 Ne Highway 99 Ste 107-78, Vancouver, WA 98665-8986 | 2018-11-19 |
| 1588149272 | Allison Rice | Technician, Other | 12650 Se 169th Pl, Renton, WA 98058-6133 | 2018-09-27 |
| 1497244552 | Kayla Grasso | Technician, Other | 18444 139th Street East, Bonney Lake, WA 98391 | 2018-05-04 |
| 1932608049 | Peach Willow LLC | Technician, Other | 9015 E Mill Plain Blvd, Vancouver, WA 98664-2536 | 2018-02-03 |
| 1124535364 | Lice Clinics of America | Technician, Other | 6632 S 191st Pl Ste E107, Kent, WA 98032-2117 | 2018-01-09 |
| 1578073029 | Evan Dyar | Technician, Other | 4713 Cottage Pl Sw, Seattle, WA 98106-1325 | 2017-10-10 |
| 1255840211 | Anne Messler | Technician, Other | 4649 Sunnyside Ave N Ste 242, Seattle, WA 98103-6955 | 2017-09-21 |
| 1760903975 | Iva Le | Technician, Other | 17500 25th Ave Ne Unit M207, Marysville, WA 98271-4749 | 2017-06-28 |
| 1720508906 | Dylan Howell | Technician, Other | 120 Ne 136th Ave Ste 220, Vancouver, WA 98684-6951 | 2017-06-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.