Healthcare Provider Details

I. General information

NPI: 1336795038
Provider Name (Legal Business Name): CHERI E SMITH MS, LRCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERI E SMITH MS, LRCP

II. Dates (important events)

Enumeration Date: 08/18/2019
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ST ANTHONY WAY
PENDLETON OR
97801-3800
US

IV. Provider business mailing address

1711 BRYANT AVE
WALLA WALLA WA
99362-9344
US

V. Phone/Fax

Practice location:
  • Phone: 616-644-6485
  • Fax: 541-278-3690
Mailing address:
  • Phone: 616-644-6485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P3900X
TaxonomyNeonatal/Pediatric Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: