Provider Demographics
NPI:1841259975
Name:HAYES, CHERYL A (DO)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:HAYES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 NW GILMAN BLVD STE 15
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5329
Mailing Address - Country:US
Mailing Address - Phone:206-914-4006
Mailing Address - Fax:
Practice Address - Street 1:1595 NW GILMAN BLVD STE 15
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5329
Practice Address - Country:US
Practice Address - Phone:206-914-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001413208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
41417OtherL & I
B48487Medicare UPIN
41417OtherL & I