Healthcare Provider Details

I. General information

NPI: 1891177143
Provider Name (Legal Business Name): ROBIN M. HERTZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3314 W MAIN ST STE 101
BATTLE GROUND WA
98604-4213
US

IV. Provider business mailing address

3314 W MAIN ST STE 101
BATTLE GROUND WA
98604-4213
US

V. Phone/Fax

Practice location:
  • Phone: 541-321-6778
  • Fax:
Mailing address:
  • Phone: 541-321-6778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3278
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3278
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: