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1982188538
CHARLES RUSSELL HERDENER
VANCOUVER, WA
NPI
1982188538
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-09-19
Last Update Date
2018-09-19
Business Address
CHARLES RUSSELL HERDENER
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661-7254
Phone number: 360-993-3000
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Mailing Address
CHARLES RUSSELL HERDENER
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661-7254
Phone number: 360-993-3000
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