Provider Demographics
NPI:1497022479
Name:HENRICHS, SHERRY LYNN (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LYNN
Last Name:HENRICHS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9975 SE TALBERT ST
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9681
Mailing Address - Country:US
Mailing Address - Phone:503-989-4290
Mailing Address - Fax:
Practice Address - Street 1:1155 NE HOGAN DR.
Practice Address - Street 2:SUITE 201
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030
Practice Address - Country:US
Practice Address - Phone:503-989-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist