Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIMOTHY P HERAN, RDN, CGD, CD
ActiveGerontological Nutrition · PORT ORCHARD, WA
Registration Details
- NPI Number
- 1669015731
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 22, 2019 (6.4989917366549 yrs)
- Last Updated
- Oct 22, 2019
- License
-
843377
Practice Information
- Address
-
1141 BEACH DR EPORT ORCHARD, WA, 983664937Browse WA providers · Browse ZIP 98366
- Phone
- 3608954668
- Primary Specialty
-
Gerontological Nutrition
133VN1101X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.