MEDICARE: CHERI SCHELL LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA00003372	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15211	OTHER	WA	LABOR & INDUSTRIES PROVID
2	EB82963W	OTHER	WA	AMERICAN WHOLEHEALTH NETW

General Provider Information

NPI Number	:	1568598019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERI SCHELL LMP

Provider Business Mailing Address
First Line	:	1930 BLACK LAKE BLVD SW
Second Line	:	SUITE 102
City	:	OLYMPIA
State	:	WA
Zip	:	98512-5651
Country	:	US
Telephone Number	:	360-352-4653
Fax Number	:	360-352-4653

Provider Business Practice Location Address
First Line	:	1930 BLACK LAKE BLVD SW
Second Line	:	SUITE 102
City	:	OLYMPIA
State	:	WA
Zip	:	98512-5651
Country	:	US
Telephone Number	:	360-352-4653
Fax Number	:	360-352-4653

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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Directions to “ CHERI SCHELL LMP” Practice Location

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