Provider Demographics
NPI:1811024813
Name:CHERYL A HAYES DO PS
Entity Type:Organization
Organization Name:CHERYL A HAYES DO PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:425-226-1190
Mailing Address - Street 1:425 SW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4926
Mailing Address - Country:US
Mailing Address - Phone:425-226-1190
Mailing Address - Fax:425-282-6753
Practice Address - Street 1:425 SW 41ST ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4926
Practice Address - Country:US
Practice Address - Phone:425-226-1190
Practice Address - Fax:425-282-6753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001413208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8863950Medicare PIN
B48487Medicare UPIN