Provider Demographics
NPI:1982789764
Name:AZLIN, CHERYL RUTH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:RUTH
Last Name:AZLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26828 MAPLE VALLEY BLACK DIAMOND RD SE # 117
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-8309
Mailing Address - Country:US
Mailing Address - Phone:508-843-0513
Mailing Address - Fax:
Practice Address - Street 1:22916 SE 241ST PL
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5248
Practice Address - Country:US
Practice Address - Phone:508-843-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003861103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W05251OtherBLUE CARE ELECT
VENDOR # A014624OtherVALUE OPTIONS
043239341OtherHEALTHCARE VALUE MGMT
04323934101OtherHARVARD PILGRIM
ITSNHMCK00OtherBEHAVIORAL HEALTH NETWORK
008964OtherVALUE OPTIONS
W05251OtherBLUE CARE 65
244786OtherMAGELLAN BEHAVIORAL HLTH
760564OtherTUFTS HEALTH PLAN
W05251OtherPERSONAL HELP CONNECTION
MAW05251OtherBLUE CROSS BLUE SHIELD
04323934101OtherPACIFICARE BEHAVIOR HLTH
W05251OtherBLUE CHOICE
0432393410002OtherCIGNA BEHAVIORAL HEALTH
1017950OtherBEACON HEALTH STRATEGIES