Individual ProviderMatthew HendersonAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address101 W 8th Ave, Spokane, WA 99204-2307(509) 474-3131(855) 600-5163PECOS EnrollmentBased on the most recent information from CMS, provider Matthew Henderson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1639438484Provider TypeIndividualFull NameHenderson, MatthewGenderMaleSole ProprietorNoEnumeration Date5/15/2012Last Updated7/21/2022Contact InformationPractice LocationPractice Address101 W 8th Ave, Spokane, WA 99204-2307Phone(509) 474-3131FaxUnlisted FaxMailing LocationMailing AddressPO Box 94645, Seattle, WA 98124-6945Phone(855) 600-5163FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseMD60751680WashingtonCode207LC0200XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseA131062CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer