Provider Demographics
NPI:1215240742
Name:STRUK, SHERI LYNN
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:STRUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:LYNN
Other - Last Name:CARDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:9725 SW WHITFORD LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9911 SE MOUNT SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-6302
Practice Address - Country:US
Practice Address - Phone:503-258-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor