| Kyle Joseph Henneberry, MD | |
|
16040 Ne 153rd St, Woodinville, WA 98072-8903 | |
| (208) 416-2932 | |
| (855) 673-9190 |
| Full Name | Kyle Joseph Henneberry |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 16040 Ne 153rd St, Woodinville, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285723957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD00047394 (Washington) | Primary |
| Entity Name | Direct Radiology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144572173 PECOS PAC ID: 9436396165 Enrollment ID: O20130805000156 |
| Entity Name | Oroville Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710372909 PECOS PAC ID: 1254234339 Enrollment ID: O20160411002032 |
| Entity Name | Radiology Alliance Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861478489 PECOS PAC ID: 1850280470 Enrollment ID: O20160822002542 |
| Entity Name | Enloe Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477975613 PECOS PAC ID: 9739092388 Enrollment ID: O20180925003908 |
| Entity Name | Jason L Hwang Md Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811486616 PECOS PAC ID: 6103171012 Enrollment ID: O20181130002453 |
| Entity Name | Simi Radiology And Imaging Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730132275 PECOS PAC ID: 6507845369 Enrollment ID: O20181210003069 |
| Entity Name | Acadiana Radiology Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649422726 PECOS PAC ID: 1355403114 Enrollment ID: O20190516001788 |
| Entity Name | Radiology Consultants Of Lynchburg Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922037043 PECOS PAC ID: 8022077205 Enrollment ID: O20190618001028 |
| Entity Name | Columbus Radiology Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467964718 PECOS PAC ID: 3971863416 Enrollment ID: O20190819001958 |
| Entity Name | Cumberland Imaging Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437279262 PECOS PAC ID: 4284735051 Enrollment ID: O20200115001017 |
| Entity Name | Tennessee Valley Radiology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356367551 PECOS PAC ID: 9133105521 Enrollment ID: O20200424001776 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Joseph Henneberry, MD 22100 Bothell Everett Hwy, Bothell, WA 98021-8431 Ph: (208) 416-2932 | Kyle Joseph Henneberry, MD 16040 Ne 153rd St, Woodinville, WA 98072-8903 Ph: (208) 416-2932 |