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General NPI Number Information
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NPI Number | 1730694357
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Entity Type | Individual
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Provider Name | EVAN DIAL HERSHBERGER
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Gender | Male
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2400 BROADWAY ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3229
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Country | US
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Telephone | 360-904-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 9904 NW RIDGECREST AVE
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City | VANCOUVER
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State | WA
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Zip | 98685-5158
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Country | US
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Telephone | 512-554-9768
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 60597867
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License Number State | WA
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