Search › Oregon › 1041C0700X
Justin Hersom, LCSW
NPI 1871937078 · on the registry since 2013
Practice
- Address
- 17250 Wilson River Hwy
Tillamook, OR 97141 - Phone
- (832) 326-8552
- Fax
- (503) 842-5035
Additional practice sites
- 1301 S Capital Of Texas Hwy, West Lake Hills, TX
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
104100000X - Licence states on file
- TX, OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-07-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon