Provider Demographics
NPI:1578633681
Name:REEVES, CHERYL J (ARNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:J
Last Name:REEVES
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 1:122 W 7TH AVE
Mailing Address - Street 2:450
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2349
Mailing Address - Country:US
Mailing Address - Phone:509-455-8820
Mailing Address - Fax:509-838-4978
Practice Address - Street 1:122 W 7TH AVE
Practice Address - Street 2:450
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2349
Practice Address - Country:US
Practice Address - Phone:509-455-8820
Practice Address - Fax:509-838-4978
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00119815163W00000X
WAAP30005425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805770600Medicaid
WA9625351Medicaid
ID805770600Medicaid
WAGAB11602Medicare PIN