Healthcare Provider Details

I. General information

NPI: 1043401623
Provider Name (Legal Business Name): CHERYL JEAN HEPKER L.M.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 MILL AVE
BELLINGHAM WA
98225-7147
US

IV. Provider business mailing address

2472 MCKENZIE AVE
BELLINGHAM WA
98225-6953
US

V. Phone/Fax

Practice location:
  • Phone: 360-961-9603
  • Fax:
Mailing address:
  • Phone: 360-733-7982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00023688
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: