Individual
CHERYL DAWN KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
118 N LIBERTY ST, APT A, PORT ANGELES, WA 98362-4322
(360) 457-7379
(360) 457-8717
Mailing address
PO BOX 121, JOYCE, WA 98343-0121
(309) 258-1187
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MA60471828
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 60471828
MASSAGE THERAPY
WA
Enumeration date
12/08/2014
Last updated
12/08/2014
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