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NPI Code Detail

MEDICARE: CHERYL DALTON

MEDICARE: CHERYL DALTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMC60614380WA

General Provider Information

NPI Number : 1639544083
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL DALTON
Provider Business Mailing Address
First Line : PO BOX 5055
Second Line :
City : NEWPORT
State : WA
Zip : 99156-5055
Country : US
Telephone Number : 509-447-5651
Fax Number : 509-447-2671
Provider Business Practice Location Address
First Line : 105 S GARDEN AVE
Second Line :
City : NEWPORT
State : WA
Zip : 99156-9001
Country : US
Telephone Number : 509-447-5651
Fax Number : 509-447-2671
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2015
Last Update Date : 12/10/2015

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Directions to “ CHERYL DALTON ” Practice Location

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