MEDICARE: RACHELLE BRENDA HERDMAN ND

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	175F00000X	Naturopath	NT00000751	WA

General Provider Information

NPI Number	:	1982717724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE BRENDA HERDMAN ND

Provider Business Mailing Address
First Line	:	1116 KEY ST
Second Line	:	SUITE 106
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-5232
Country	:	US
Telephone Number	:	360-734-0045
Fax Number	:	360-715-3060

Provider Business Practice Location Address
First Line	:	1116 KEY ST
Second Line	:	SUITE 106
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-5232
Country	:	US
Telephone Number	:	360-734-0045
Fax Number	:	360-715-3060

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/08/2007

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