Provider Demographics
NPI:1295864023
Name:HERRICK, LINDA ELYSSIA (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ELYSSIA
Last Name:HERRICK
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3228
Mailing Address - Country:US
Mailing Address - Phone:541-482-0409
Mailing Address - Fax:
Practice Address - Street 1:586 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3228
Practice Address - Country:US
Practice Address - Phone:541-482-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR00087171100000X
OR0603175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath