Provider Demographics
NPI:1053052654
Name:HURD, CHEYENNE ELAINE (LMT)
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:ELAINE
Last Name:HURD
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 1:610 N MISSION ST STE 102
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6612
Mailing Address - Country:US
Mailing Address - Phone:509-662-4711
Mailing Address - Fax:509-662-2800
Practice Address - Street 1:610 N MISSION ST STE 102
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6612
Practice Address - Country:US
Practice Address - Phone:509-662-4711
Practice Address - Fax:509-662-2800
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61227699225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist