Provider Demographics
NPI:1982717724
Name:HERDMAN, RACHELLE BRENDA (ND)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:BRENDA
Last Name:HERDMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 KEY ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5232
Mailing Address - Country:US
Mailing Address - Phone:360-734-0045
Mailing Address - Fax:360-715-3060
Practice Address - Street 1:1116 KEY ST
Practice Address - Street 2:SUITE 106
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5232
Practice Address - Country:US
Practice Address - Phone:360-734-0045
Practice Address - Fax:360-715-3060
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000751175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath