Provider Demographics
NPI:1134127095
Name:BATTY, CHERYL (DPT)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:BATTY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NORTH LAVENTURE ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-3901
Mailing Address - Country:US
Mailing Address - Phone:360-428-2700
Mailing Address - Fax:360-428-2701
Practice Address - Street 1:110 NORTH LAVENTURE ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3901
Practice Address - Country:US
Practice Address - Phone:360-428-2700
Practice Address - Fax:360-428-2701
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0161896OtherLABOR AND INDUSTRIES
WA8321234Medicaid
WAGAB32203Medicare PIN
WA8321234Medicaid
WA0161896OtherLABOR AND INDUSTRIES