Charles Russell Herdener Jr.
Counselor, Addiction (Substance Use Disorder) in Vancouver, WA. Individual provider (NPI-1).
NPI number1982188538
StatusActive
Last updated in NPPESSep 19, 2018
Details
- NPI
- 1982188538
- Entity type
- Individual (NPI-1)
- Name
- Charles Russell Herdener Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2018
- Last updated
- Sep 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
6926 Ne Fourth Plain BlvdVancouver, WA 98661-7254
Phone 360-993-3000
Mailing address
6926 Ne Fourth Plain BlvdVancouver, WA 98661-7254
Phone 360-993-3000
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