Healthcare Provider Details

I. General information

NPI: 1730309261
Provider Name (Legal Business Name): CHERISE BASQUES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERISE HAZLET-LINDLEY

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29700 SW MOUNTAIN RD
WEST LINN OR
97068-9649
US

IV. Provider business mailing address

9755 SW KILLARNEY LN
TUALATIN OR
97062-7516
US

V. Phone/Fax

Practice location:
  • Phone: 971-930-9820
  • Fax:
Mailing address:
  • Phone: 971-930-9820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number229698
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: