Individual
DR. GARY KEITH HERMANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
308 DONAHUE ST, SAUSALITO, CA 94965-1032
(415) 535-3659
Mailing address
308 DONAHUE ST, SAUSALITO, CA 94965-1032
(415) 535-3659
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1008
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7066932-8900
UT
Other
Enumeration date
01/08/2007
Last updated
07/17/2019
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