Provider Demographics
NPI:1619151164
Name:DANIEL L HIERSCHE, PLLC
Entity Type:Organization
Organization Name:DANIEL L HIERSCHE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIERSCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-962-6727
Mailing Address - Street 1:700 E MANITOBA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3885
Mailing Address - Country:US
Mailing Address - Phone:509-962-6727
Mailing Address - Fax:509-962-1994
Practice Address - Street 1:700 E MANITOBA AVE STE 106
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3885
Practice Address - Country:US
Practice Address - Phone:509-962-6727
Practice Address - Fax:509-962-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00022370174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1115476Medicaid
WA157669OtherLABOR & INDUSTRIES
WA1115476Medicaid