IndividualActive
Thiebaut Herzog
NPI 1114344058 · Pediatrics Physician · Bend, OR
Provider details
- NPI number
- 1114344058
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- 1114344058 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2500 Ne Neff Rd
Bend, OR 97701-6015
Phone: (541) 382-4321
Street-level locationGet directions
Mailing address
2801 N Gantenbein Ave
Portland, OR 97227-1623
Additional practice locations (2)
- 2801 N Gantenbein AvePortland, OR 97227-1623Phone: (503) 276-6500
- 4800 Sand Point Way Ne # Oc.7830Seattle, WA 98105-3901Phone: (206) 987-2525
Registry dates
- Enumerated
- 2014-03-27
- Last updated
- 2022-11-03
- Certified
- 2022-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.