Provider Demographics
NPI:1942229588
Name:NEWREN, CHERYL ANN (PA/SA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:NEWREN
Suffix:
Gender:F
Credentials:PA/SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29247 54TH PL S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-2157
Mailing Address - Country:US
Mailing Address - Phone:253-941-7974
Mailing Address - Fax:253-941-7241
Practice Address - Street 1:29247 54TH PL S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-2157
Practice Address - Country:US
Practice Address - Phone:253-941-7974
Practice Address - Fax:253-941-7241
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10002134363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical