Provider Demographics
NPI:1699834689
Name:DUNHAM, CHERYL RENEE (RN BSN)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:RENEE
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:RENEE
Other - Last Name:DAEHLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN BSN
Mailing Address - Street 1:PO BOX 1323
Mailing Address - Street 2:515 W COURT ST
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301
Mailing Address - Country:US
Mailing Address - Phone:509-547-2204
Mailing Address - Fax:509-542-8836
Practice Address - Street 1:720 W COURT ST
Practice Address - Street 2:#8
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301
Practice Address - Country:US
Practice Address - Phone:509-545-6506
Practice Address - Fax:509-546-0520
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00066266163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult