Provider Demographics
NPI:1154549392
Name:MATHER, HENDRIKA (MS)
Entity type:Individual
Prefix:
First Name:HENDRIKA
Middle Name:
Last Name:MATHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 N PEARL ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3193
Mailing Address - Country:US
Mailing Address - Phone:509-925-7522
Mailing Address - Fax:
Practice Address - Street 1:421 N PEARL ST
Practice Address - Street 2:SUITE 209
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3193
Practice Address - Country:US
Practice Address - Phone:509-925-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30002968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health