Provider Demographics
NPI:1447282280
Name:GUILMETTE, SHERRIE LEE (LMT)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:LEE
Last Name:GUILMETTE
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 1:17913 TUALATA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-7135
Mailing Address - Country:US
Mailing Address - Phone:503-314-4719
Mailing Address - Fax:
Practice Address - Street 1:19300 SW BOONES FERRY RD
Practice Address - Street 2:STE D
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062
Practice Address - Country:US
Practice Address - Phone:503-692-6568
Practice Address - Fax:503-692-7212
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR923225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist