Healthcare Provider Details

I. General information

NPI: 1134127095
Provider Name (Legal Business Name): CHERYL BATTY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NORTH LAVENTURE ROAD SUITE A
MOUNT VERNON WA
98273-3901
US

IV. Provider business mailing address

110 NORTH LAVENTURE ROAD SUITE A
MOUNT VERNON WA
98273-3901
US

V. Phone/Fax

Practice location:
  • Phone: 360-428-2700
  • Fax: 360-428-2701
Mailing address:
  • Phone: 360-428-2700
  • Fax: 360-428-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00008851
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: