Provider Demographics
NPI:1396571964
Name:DAUGHERTY, CIERRA NICOLE (AUD)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:NICOLE
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 REDWING RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-8206
Mailing Address - Country:US
Mailing Address - Phone:360-771-9158
Mailing Address - Fax:
Practice Address - Street 1:801 W 5TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2800
Practice Address - Country:US
Practice Address - Phone:509-342-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist