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Individual

OSCAR HERRERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
220 15TH AVE SE, PUYALLUP, WA 98372-3797
(253) 697-8610
Mailing address
220 15TH AVE SE, PUYALLUP, WA 98372-3797

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60957049
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60957049
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2141636
WA
Enumeration date
07/29/2019
Last updated
11/03/2023
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