Provider Demographics
NPI:1871955104
Name:HENTO, ERIN (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HENTO
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13916 N CREEK DR
Mailing Address - Street 2:APT. 3131
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8416
Mailing Address - Country:US
Mailing Address - Phone:503-881-5922
Mailing Address - Fax:
Practice Address - Street 1:6001 36TH AVE W
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-1264
Practice Address - Country:US
Practice Address - Phone:503-881-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1606514652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer