Kenneth Hans Hermansen, RDN, CDCES

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI61408612 Issued in WA

Practice address

1044 11TH Ave
Longview, WA 98632-2506

Phone

(360) 575-8275

Fax

(360) 353-9440

NPI assigned

Feb 8, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cowlitz Indian TribeGroup PAC ID 8820030133, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cowlitz Indian Tribe

  • Clinic/Center
  • Longview, WA
  • NPI 1740562909

  TX

  Medicare reassignment Care Compare group NPD
• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• Cowlitz Indian Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1538412630
  NPD
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
  • NPI 1760004477
  NPD
• Cowlitz Indian Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1164649679
  NPD (past)
• Cowlitz Indian Tribe

  • Public Health & General Preventive Medicine Physician
  • Longview, WA
  • NPI 1619194123
  NPD (past)
• Cowlitz Indian Tribe

  • General Practice Physician
  • Longview, WA
  • NPI 1851328447
  NPD (past)
• Cowlitz Indian Tribe

  • Public Health & General Preventive Medicine Physician
  • Vancouver, WA
  • NPI 1972962165
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1558068791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-353-9494",
            "fax_number": "360-353-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322506",
            "telephone_number": "360-575-8275",
            "fax_number": "360-353-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANSEN",
        "first_name": "KENNETH",
        "middle_name": "HANS",
        "credential": "RDN, CDCES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "275943",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61408612",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "11870717-4901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernest P Hensley, MA, LMHC
• Luciana Marie Henson-Anguilla
• Melissa S Hepler, SUDP
• Krista R Heppe, CP
• Michael James Heriford, R.PH.
• Lee Wardle Hermen, DDS
• Jessica Lassette Hernandez-Gonzales, PT, DPT
• Joseph Phillip Hernandez
• Evelyn R Heroux
• Katy Arleen Herr, PSY.D

• Registered Dietitian in Longview, WA
• Providers in Longview, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.