IndividualActive
Micaela Hersh
NPI 1164240040 · Pharmacy · Corvallis, OR
Provider details
- NPI number
- 1164240040
- Entity type
- Individual
- Primary specialty
- PharmacySuppliers
- Sex
- Female
- Sole proprietor
- Yes
- License
- PI-0014100 (OR)
Mailing address
7731 E Northern Lights Blvd
Anchorage, AK 99504-3572
Registry dates
- Enumerated
- 2024-09-30
- Last updated
- 2025-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.