Individual
MANDA JANE HERSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
702 CHURCH ST NE, SALEM, OR 97301-2404
(503) 991-5903
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
(602) 854-0504
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
202009204LPN
OR
Other
Enumeration date
07/01/2026
Last updated
07/01/2026
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