Healthcare Provider Details

I. General information

NPI: 1013470699
Provider Name (Legal Business Name): CHERYL ANN SNYDER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 04/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21231 PIONEER WAY
EDMONDS WA
98026-7342
US

IV. Provider business mailing address

21231 PIONEER WAY
EDMONDS WA
98026-7342
US

V. Phone/Fax

Practice location:
  • Phone: 206-755-4178
  • Fax:
Mailing address:
  • Phone: 206-755-4178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60920957
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: