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Individual

MRS. CHERYL LYNN FRIED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
15324 MAIN ST E, SUITE B, SUMNER, WA 98390-2698
(253) 225-1649
Mailing address
3219 170TH AVE E, LAKE TAPPS, WA 98391-5530
(253) 225-1649

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00011173
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123246
LABOR AND INDUSTRY
WA
01
5899FR
REGENCE BLUE SHIELD
WA
Enumeration date
11/06/2006
Last updated
07/08/2007
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