Provider Demographics
NPI:1447993902
Name:CHERICO, TRISHA (RD)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:CHERICO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:CHERICO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:86 PARK CIR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 NE 134TH ST STE 180C
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2799
Practice Address - Country:US
Practice Address - Phone:360-450-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86014507133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered