Henneman, Scott Randall
Henneman, Scott Randall is an individual health care provider with primary practice located at 1304 Fawcett Ave Ste 100 , Tacoma WA 98402. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Henneman, Scott Randall can be contacted via phone (253) 761-4200.Contact Information
Primary practice address
1304 Fawcett Ave Ste 100
Tacoma WA 98402
Phone: (253) 761-4200
Fax: (253) 761-4201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | MD187713 | Oregon |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | MD60392348 | Washington |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD187713 | Oregon |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD60392348 | Washington |
Profile Details
| NPI number | 1013173814 |
|---|---|
| LBN Legal business name | Henneman, Scott Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2008 |
| Last updated | Jul 10th, 2024 - about 4 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013173814 | NPPES |
| Washington | MEDICAID | 2029105 |
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