Provider Demographics
NPI:1538223359
Name:MARSHALL, CHERYL LYNN (MSW)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:HEROD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:201 N. EDISON ST.
Mailing Address - Street 2:SUITE 233
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336
Mailing Address - Country:US
Mailing Address - Phone:509-736-6605
Mailing Address - Fax:509-736-6607
Practice Address - Street 1:77 WAINWRIGHT DR
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3975
Practice Address - Country:US
Practice Address - Phone:509-525-5200
Practice Address - Fax:509-736-6607
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2024-06-11
Deactivation Date:2017-03-27
Deactivation Code:
Reactivation Date:2017-03-27
Provider Licenses
StateLicense IDTaxonomies
WAMA00015285225700000X
WA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist