Hermen, Lee Wardle

Hermen, Lee Wardle is an individual health care provider with primary practice located at 1057 12Th Ave , Longview WA 98632-2509. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Hermen, Lee Wardle can be contacted via phone (360) 414-1300.

Contact Information

Primary practice address
1057 12Th Ave Longview WA 98632-2509
Phone: (360) 414-1300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DE 60013005 Washington

Profile Details

NPI number 1649336470
LBN Legal business name Hermen, Lee Wardle
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Oct 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649336470 NPPES
Washington MEDICAID 1092355

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