Provider Demographics
NPI:1043737539
Name:CHENELL, SHERRY LYNNE (MS, PMHNP, PMHCNS)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LYNNE
Last Name:CHENELL
Suffix:
Gender:F
Credentials:MS, PMHNP, PMHCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13663 S SPANGLER RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-9551
Mailing Address - Country:US
Mailing Address - Phone:503-957-4857
Mailing Address - Fax:503-632-7605
Practice Address - Street 1:13663 S SPANGLER RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-9551
Practice Address - Country:US
Practice Address - Phone:503-957-4857
Practice Address - Fax:503-632-7605
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR081034855N6363LP0808X
OR200170086CNS364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health