Provider Demographics
NPI:1972610251
Name:BOEDIGHEIMER, CHERYL LEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LEE
Last Name:BOEDIGHEIMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:LEE
Other - Last Name:FORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7101 NE 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-4933
Mailing Address - Country:US
Mailing Address - Phone:360-944-4993
Mailing Address - Fax:360-944-4987
Practice Address - Street 1:7101 NE 137TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-4933
Practice Address - Country:US
Practice Address - Phone:360-944-4993
Practice Address - Fax:360-944-4987
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2579225100000X
WAPT60019567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist