Wallen, Herschel D
Wallen, Herschel D is an individual health care provider with primary practice located at 441 Nw Elks Dr Ste 100 , Corvallis OR 97330-3744. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Wallen, Herschel D can be contacted via phone (541) 768-4950.Contact Information
Primary practice address
441 Nw Elks Dr Ste 100
Corvallis OR 97330-3744
Phone: (541) 768-4950
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | MD00040124 | Washington |
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | MD153740 | Oregon |
Profile Details
| NPI number | 1710924451 |
|---|---|
| LBN Legal business name | Wallen, Herschel D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Aug 7th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710924451 | NPPES |
| Oregon | MEDICAID | 500631243 | |
| Oregon | MEDICAID | 8455354 | |
| Oregon | Other | 8883097 |
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