Provider Demographics
NPI:1457695181
Name:HERBERT, JOSEPH F
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:HERBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 PLAZA WAY
Mailing Address - Street 2:STE A
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4351
Mailing Address - Country:US
Mailing Address - Phone:509-529-8625
Mailing Address - Fax:509-529-8629
Practice Address - Street 1:1423 PLAZA WAY
Practice Address - Street 2:STE A
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4351
Practice Address - Country:US
Practice Address - Phone:509-529-8625
Practice Address - Fax:509-529-8629
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA00000918237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist