Healthcare Provider Details

I. General information

NPI: 1518594639
Provider Name (Legal Business Name): CHERYL L. E. WATSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERI WATSON MD

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 COLLEGE ST SE
LACEY WA
98503-4389
US

IV. Provider business mailing address

4800 COLLEGE ST SE
LACEY WA
98503-4389
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-4250
  • Fax: 360-412-2262
Mailing address:
  • Phone: 360-413-4250
  • Fax: 360-412-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD61662626
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: