Provider Demographics
NPI:1043401623
Name:HEPKER, CHERYL JEAN (LMT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:JEAN
Last Name:HEPKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 MCKENZIE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6953
Mailing Address - Country:US
Mailing Address - Phone:360-733-7982
Mailing Address - Fax:
Practice Address - Street 1:1215 MILL AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7147
Practice Address - Country:US
Practice Address - Phone:360-961-9603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023688225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist