Provider Demographics
NPI:1891137766
Name:SHERRY ELWOOD RN DBA RIVERHAVEN
Entity Type:Organization
Organization Name:SHERRY ELWOOD RN DBA RIVERHAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-369-0918
Mailing Address - Street 1:1723 166TH PL SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8059
Mailing Address - Country:US
Mailing Address - Phone:206-369-0918
Mailing Address - Fax:425-487-2049
Practice Address - Street 1:1723 166TH PL SE
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-8059
Practice Address - Country:US
Practice Address - Phone:206-369-0918
Practice Address - Fax:425-487-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-21
Last Update Date:2013-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00092138163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty