Individual
DR. HERSCHEL D WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
441 NW ELKS DR STE 100, CORVALLIS, OR 97330-3744
(541) 768-4950
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
MD00040124
WA
207RX0202X
Medical Oncology Physician
Primary
MD153740
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500631243
—
OR
05
—
8455354
—
WA
01
—
8883097
MEDICARE - KITSAP CO
WA
Enumeration date
06/01/2006
Last updated
08/07/2023
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