Individual
GLENN HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 29TH ST NE, PUYALLUP, WA 98372-6774
(253) 840-4400
Mailing address
2366 COURT G, TACOMA, WA 98405-4300
(253) 797-0668
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60267435
WA
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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