Provider Demographics
NPI:1043912926
Name:MAUSHAK, CHERISH L (LMT)
Entity type:Individual
Prefix:
First Name:CHERISH
Middle Name:L
Last Name:MAUSHAK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-0069
Mailing Address - Country:US
Mailing Address - Phone:405-519-6738
Mailing Address - Fax:
Practice Address - Street 1:16811 BRENDA DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97707-2308
Practice Address - Country:US
Practice Address - Phone:405-519-6738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR26833225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist