Provider Demographics
NPI:1093150914
Name:CICHOSKI, SHEILA ANN (LMP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:CICHOSKI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 COOKS HILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-9072
Mailing Address - Country:US
Mailing Address - Phone:360-736-2853
Mailing Address - Fax:360-736-4159
Practice Address - Street 1:1800 COOKS HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-9072
Practice Address - Country:US
Practice Address - Phone:360-736-2853
Practice Address - Fax:360-736-4159
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist