Provider Demographics
NPI:1285770958
Name:SHERWOOD, KATHLEEN SUE (ATC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:SUE
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 E 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4360
Mailing Address - Country:US
Mailing Address - Phone:541-343-1315
Mailing Address - Fax:541-343-3462
Practice Address - Street 1:680 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4360
Practice Address - Country:US
Practice Address - Phone:541-343-1315
Practice Address - Fax:541-343-3462
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical