Provider Demographics
NPI:1629634019
Name:LEWIS, SHERIKHA CHERMAINE (LMT, ND)
Entity Type:Individual
Prefix:MS
First Name:SHERIKHA
Middle Name:CHERMAINE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMT, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 NE DONCASTER LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9047
Mailing Address - Country:US
Mailing Address - Phone:340-514-0899
Mailing Address - Fax:
Practice Address - Street 1:16088 BOONES FERRY RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4370
Practice Address - Country:US
Practice Address - Phone:503-376-6928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-12
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23605225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR23605OtherLMT LICENSE NUMBER