Provider Demographics
NPI:1841593530
Name:HANKAL, CHERIE RENEE (LMP, LMT)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:RENEE
Last Name:HANKAL
Suffix:
Gender:F
Credentials:LMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3684B SIMMONS MILL CT SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7804
Mailing Address - Country:US
Mailing Address - Phone:360-335-7120
Mailing Address - Fax:
Practice Address - Street 1:4525 3RD AVE SE
Practice Address - Street 2:SUITE 200
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1010
Practice Address - Country:US
Practice Address - Phone:360-335-7120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60191440225700000X
OR17771225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist