Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | P0000464 | WA |
Y | 222Z00000X | Podiatrist | P0000464 | WA |
NPI | 1053481200 |
---|---|
Provider Name | Kirk Maclennan Herring |
First Address | Spokane Valley, WA 99216 |
Second Address | Spokane Valley, WA 99216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 13/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1080274 | (05) | WA |
33897 | LABOR & INDUSTRY (01) | |
480012182 | RAILROAD MEDICARE (01) | |
U00877 | (02) |