Provider Demographics
NPI:1346435237
Name:PRITCHETT, CHERYL MARIE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:MARIE
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NE PARK DRIVE
Mailing Address - Street 2:SUITE 246
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-0000
Mailing Address - Country:US
Mailing Address - Phone:360-696-1070
Mailing Address - Fax:360-737-0200
Practice Address - Street 1:201 NE PARK PLAZA DRIVE
Practice Address - Street 2:SUITE 246
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5874
Practice Address - Country:US
Practice Address - Phone:360-696-1070
Practice Address - Fax:360-737-0200
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR07447174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist