Active NPI
Lourdes M Herrera, M.S.P.T.
- Neurology Physical Therapist
- Vancouver, WA
National Provider Identifier
1093828170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- PT00006874
- Practice address
- 14411 NE 20TH Ave Ste 101
Vancouver, WA 98686-6432 - Phone
- (360) 574-9293
- Fax
- (360) 574-9283
- NPI assigned
- Aug 16, 2006
- Last updated
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | PT00006874 | WA | Primary |
Addresses
Primary practice location
14411 NE 20TH Ave Ste 101
Vancouver, WA 98686-6432
Mailing address
1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644
Phone (360) 256-4425
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8436891 | Medicaid | WA | |
| 8941150 | Other | WA | WA DEPT OF L&I CRIME VICT |
| 0205240 | Other | WA | WA DEPT OF LABOR & INDUST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00006874 | WA | MD | Neurology Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1093828170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 SE 164TH AVE STE 102",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839644",
"telephone_number": "360-256-4425",
"fax_number": "360-254-1844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14411 NE 20TH AVE STE 101",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986866432",
"telephone_number": "360-574-9293",
"fax_number": "360-574-9283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRERA",
"first_name": "LOURDES",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "M.S.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "WA",
"license": "PT00006874",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8436891",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA DEPT OF L&I CRIME VICT",
"identifier": "8941150",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA DEPT OF LABOR & INDUST",
"identifier": "0205240",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.