Provider Demographics
NPI:1710489380
Name:HORVAT, SHERI ALISA (LMT)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:ALISA
Last Name:HORVAT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-7476
Mailing Address - Country:US
Mailing Address - Phone:310-944-2031
Mailing Address - Fax:
Practice Address - Street 1:303 CASCADE AVE
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2021
Practice Address - Country:US
Practice Address - Phone:310-944-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist