Individual
KACY L HERBST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1410 NE 106TH AVE, PORTLAND, OR 97220-3934
(503) 460-0405
(503) 460-0434
Mailing address
1410 NE 106TH AVE, PORTLAND, OR 97220-3934
(503) 460-0405
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10043172
OR
Other
Enumeration date
04/11/2025
Last updated
04/30/2025
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