Provider Demographics
NPI:1770619512
Name:KERCHNER, SHERRY JA (ND)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:JA
Last Name:KERCHNER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 EASTLAKE AVE E
Mailing Address - Street 2:SUITE 223
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3366
Mailing Address - Country:US
Mailing Address - Phone:206-323-7864
Mailing Address - Fax:206-323-7397
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:SUITE 223
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-323-7864
Practice Address - Fax:206-323-7397
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000803175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANT000803OtherNATUROPATHIC LICENSE