Provider Demographics
NPI:1962832212
Name:EDEN, SHERRI R (BS, MS, CHT)
Entity Type:Individual
Prefix:MISS
First Name:SHERRI
Middle Name:R
Last Name:EDEN
Suffix:
Gender:F
Credentials:BS, MS, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 S PALOUSE HWY
Mailing Address - Street 2:381C
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7802
Mailing Address - Country:US
Mailing Address - Phone:509-995-9743
Mailing Address - Fax:
Practice Address - Street 1:5317 S PALOUSE HWY
Practice Address - Street 2:381C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7802
Practice Address - Country:US
Practice Address - Phone:509-995-9743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-23
Last Update Date:2013-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHP60406911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health