Individual
MICHELE MARIE HERZOG-DIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4400 SE RISLEY AVE, MILWAUKIE, OR 97267-2954
(971) 998-4442
(503) 850-4651
Mailing address
4400 SE RISLEY AVE, MILWAUKIE, OR 97267-2954
(971) 998-4442
(503) 850-4651
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
4576
OR
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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