Healthcare Provider Details
I. General information
NPI: 1518508738
Provider Name (Legal Business Name): CHERYL ANN HOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/30/2019
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19657 SW ROCK CREEK RD
SHERIDAN OR
97378-9739
US
IV. Provider business mailing address
19657 SW ROCK CREEK RD
SHERIDAN OR
97378-9739
US
V. Phone/Fax
- Phone: 503-843-2428
- Fax:
- Phone: 503-843-2428
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: