Provider Demographics
NPI:1386829505
Name:CLAWSON, CHERIE R (LMP)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:R
Last Name:CLAWSON
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 1:19321 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-5553
Mailing Address - Country:US
Mailing Address - Phone:360-887-8600
Mailing Address - Fax:360-887-4541
Practice Address - Street 1:19321 NE 10TH AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-5553
Practice Address - Country:US
Practice Address - Phone:360-887-8600
Practice Address - Fax:360-887-4541
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004761174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist