Provider Demographics
NPI:1780304758
Name:JIMENEZ-HERZ, DIEGO (RD)
Entity type:Individual
Prefix:MR
First Name:DIEGO
Middle Name:
Last Name:JIMENEZ-HERZ
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 PACE DR
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5477
Mailing Address - Country:US
Mailing Address - Phone:713-259-9764
Mailing Address - Fax:
Practice Address - Street 1:625 OKANOGAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6409
Practice Address - Country:US
Practice Address - Phone:509-663-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered