Provider Demographics
NPI:1710083316
Name:MAR, SHERI K (CN)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:K
Last Name:MAR
Suffix:
Gender:F
Credentials:CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17468
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98127-1168
Mailing Address - Country:US
Mailing Address - Phone:206-789-6440
Mailing Address - Fax:
Practice Address - Street 1:500 WALL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1527
Practice Address - Country:US
Practice Address - Phone:206-789-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU00001330133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist