Individual
DIANA HEREDIA-IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3512 NE 104TH ST, VANCOUVER, WA 98686-5729
(360) 843-8164
Mailing address
3512 NE 104TH ST, VANCOUVER, WA 98686-5729
(360) 843-8164
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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