Provider Demographics
NPI:1447428370
Name:FISHER, CHERYL LEE (LMP)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LEE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 FRONT ST S
Mailing Address - Street 2:D211
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-4249
Mailing Address - Country:US
Mailing Address - Phone:425-283-8621
Mailing Address - Fax:
Practice Address - Street 1:12951 BEL RED RD
Practice Address - Street 2:SUITE 120
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2644
Practice Address - Country:US
Practice Address - Phone:425-455-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024650174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist