Provider Demographics
NPI:1407810294
Name:BAUERMEISTER, CHERYL LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:BAUERMEISTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4201
Mailing Address - Country:US
Mailing Address - Phone:206-329-1760
Mailing Address - Fax:206-325-6910
Practice Address - Street 1:904 7TH AVE
Practice Address - Street 2:7TH FLOOR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1132
Practice Address - Country:US
Practice Address - Phone:206-860-4669
Practice Address - Fax:206-860-2269
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006614363L00000X
WARN00082551163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3478BAOtherBLUE SHIELD # VM
AKNP027WAMedicaid
WA0039571OtherLABOR AND INDUSTRIES # VM
WAP00393161OtherRAILROAD MC #
WA9639956Medicaid
WA9639956Medicaid
AKNP027WAMedicaid
WA8867591Medicare PIN