Provider Demographics
NPI:1063395572
Name:HERRERA, XIMENA RAQUEL
Entity type:Individual
Prefix:
First Name:XIMENA
Middle Name:RAQUEL
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3842 E HOWE ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-3728
Mailing Address - Country:US
Mailing Address - Phone:360-812-1469
Mailing Address - Fax:
Practice Address - Street 1:6112 GOULD AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-2959
Practice Address - Country:US
Practice Address - Phone:202-780-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician