Provider Demographics
NPI:1366482713
Name:NEVIN, CHERYL FRENCH (MS,PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:FRENCH
Last Name:NEVIN
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,PT
Mailing Address - Street 1:9315 GRAVELLY LAKE DR SW
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1574
Mailing Address - Country:US
Mailing Address - Phone:253-581-5200
Mailing Address - Fax:253-581-5203
Practice Address - Street 1:9514 GRAVELLY LAKE DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1514
Practice Address - Country:US
Practice Address - Phone:253-983-9395
Practice Address - Fax:253-983-9411
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA53646OtherLABOR & INDUSTRIES
WA8910676OtherL&I CRIME VICTIMS PROGRAM
WA7727NEOtherREGENCE BLUESHIELD
WA8346843Medicaid
WA8910676OtherL&I CRIME VICTIMS PROGRAM
WA53646OtherLABOR & INDUSTRIES