Individual
CHARLES RUSSELL HERDENER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7254
(360) 993-3000
Mailing address
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7254
(360) 993-3000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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