Provider Demographics
NPI:1588602544
Name:HERT, SHERRI (LMT, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:HERT
Suffix:
Gender:F
Credentials:LMT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 N 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:OR
Mailing Address - Zip Code:97113-8111
Mailing Address - Country:US
Mailing Address - Phone:503-648-4901
Mailing Address - Fax:503-648-4901
Practice Address - Street 1:182 N 31ST AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:OR
Practice Address - Zip Code:97113-8111
Practice Address - Country:US
Practice Address - Phone:503-648-4901
Practice Address - Fax:503-648-4901
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7037225700000X
OR3584225X00000X
WAOT00002199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist