Provider Demographics
NPI:1700106226
Name:CRUTCHER, KERISHA MAE (MS)
Entity Type:Individual
Prefix:
First Name:KERISHA
Middle Name:MAE
Last Name:CRUTCHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8862 BENDER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-8800
Mailing Address - Country:US
Mailing Address - Phone:206-817-5654
Mailing Address - Fax:
Practice Address - Street 1:400 SEQUOIA DR
Practice Address - Street 2:STE 120
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7133
Practice Address - Country:US
Practice Address - Phone:206-817-5654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist