Provider Demographics
NPI:1316387160
Name:MORELLI, SHERYL LYNN (LMP)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNN
Last Name:MORELLI
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 1:311 CHAMPION ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1107
Mailing Address - Country:US
Mailing Address - Phone:360-789-3906
Mailing Address - Fax:
Practice Address - Street 1:311 CHAMPION ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-1107
Practice Address - Country:US
Practice Address - Phone:360-789-3906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021562172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist