Provider Demographics
NPI:1881147791
Name:ZAL-HERWITZ, CHRISTIAN (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:ZAL-HERWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:
Other - Last Name:HERWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:VA SOUTHERN OREGON REHABILITATION CENTER & CLINICS
Mailing Address - Street 2:8495 CRATER LAKE HWY
Mailing Address - City:WHITE CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97503
Mailing Address - Country:US
Mailing Address - Phone:541-826-2111
Mailing Address - Fax:
Practice Address - Street 1:VA SOUTHERN OREGON REHABILITATION CENTER & CLINICS
Practice Address - Street 2:8495 CRATER LAKE HWY
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503
Practice Address - Country:US
Practice Address - Phone:541-826-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2878103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical