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Individual

MICHELLE LYNN HERRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
6342 LITTLEROCK RD SW, TUMWATER, WA 98512-7332
(360) 520-3011
Mailing address
6342 LITTLEROCK RD SW, TUMWATER, WA 98512-7332
(360) 520-3011

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022554
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA00022554
LMP
WA
Enumeration date
06/02/2008
Last updated
08/24/2015
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