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General NPI Number Information
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NPI Number | 1174464317
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Entity Type | Individual
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Provider Name | JADE JOY HERRIN
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 3025 LANCASTER DR NE # DE
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City | SALEM
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State | OR
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Zip | 97305-1391
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Country | US
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Telephone | 503-362-5982
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Fax |
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Provider Business Mailing Address
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Address Line | 835 PIEDMONT AVE NW APT 3
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City | SALEM
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State | OR
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Zip | 97304-3700
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Country | US
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Telephone | 503-362-5982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 267546
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License Number State | OR
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