Provider Demographics
NPI:1215227491
Name:PINNOCK, CHERALEE K (LMP)
Entity Type:Individual
Prefix:
First Name:CHERALEE
Middle Name:K
Last Name:PINNOCK
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 1:22910 E APPLEWAY AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-8606
Mailing Address - Country:US
Mailing Address - Phone:509-242-0911
Mailing Address - Fax:509-242-0913
Practice Address - Street 1:22910 E APPLEWAY AVE STE 7
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-8606
Practice Address - Country:US
Practice Address - Phone:509-242-0911
Practice Address - Fax:509-242-0913
Is Sole Proprietor?:No
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00019826225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist