Provider Demographics
NPI:1225854508
Name:HERMENS, KIRSTEN LEIGH (NCMA)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LEIGH
Last Name:HERMENS
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9851 SW LANCEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:AMITY
Mailing Address - State:OR
Mailing Address - Zip Code:97101-2203
Mailing Address - Country:US
Mailing Address - Phone:971-517-8827
Mailing Address - Fax:
Practice Address - Street 1:9851 SW LANCEFIELD RD
Practice Address - Street 2:
Practice Address - City:AMITY
Practice Address - State:OR
Practice Address - Zip Code:97101-2203
Practice Address - Country:US
Practice Address - Phone:971-517-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider