Active NPI
Sherry Anne Champion, P.T.
- Physical Therapist
- Vancouver, WA
National Provider Identifier
1043408909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009313
- Practice address
- 5220 NE Hazel Dell Ave
Vancouver, WA 98663-1242 - Phone
- (360) 693-1474
- NPI assigned
- Oct 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00009313 | WA | Primary |
Addresses
Primary practice location
5220 NE Hazel Dell Ave
Vancouver, WA 98663-1242
Mailing address
6715 NE 63Rd St # 470
Vancouver, WA 98661-1980
Phone (360) 750-4784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00009313 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1043408909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6715 NE 63RD ST # 470",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986611980",
"telephone_number": "360-750-4784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5220 NE HAZEL DELL AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986631242",
"telephone_number": "360-693-1474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPION",
"first_name": "SHERRY",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-04",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.