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1891028817

NPI Code Detail

MEDICARE: MICHAEL DAVID HERMAN PSYD

MEDICARE: MICHAEL DAVID HERMAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist
2	103TB0200X	Cognitive & Behavioral Psychologist	2140	OR
3	103TC0700X	Clinical Psychologist	2140	OR
4	103TH0004X	Health Psychologist	2140	OR
5	103T00000X	Psychologist	2140	OR

General Provider Information

NPI Number	:	1891028817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DAVID HERMAN PSYD

Provider Business Mailing Address
First Line	:	444 NW ELKS DR
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97330-3745
Country	:	US
Telephone Number	:	415-754-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	633 N ALBANY RD NW
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-1433
Country	:	US
Telephone Number	:	541-926-3441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2009
Last Update Date	:	06/03/2021

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Directions to “ MICHAEL DAVID HERMAN PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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