Individual
KATHLEEN HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1338 COMMERCE AVE STE 106, LONGVIEW, WA 98632-3732
(971) 915-8587
(503) 362-8435
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61098708
WA
363AS0400X
Surgical Physician Assistant
7266
AZ
Other
Enumeration date
10/10/2018
Last updated
10/15/2024
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