Provider Demographics
NPI:1356480560
Name:ENSING, CHERYL (LAC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ENSING
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-0141
Mailing Address - Country:US
Mailing Address - Phone:360-336-2794
Mailing Address - Fax:
Practice Address - Street 1:422 N 4TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2856
Practice Address - Country:US
Practice Address - Phone:360-336-2794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC0001816171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist