Basic Information
| Provider Information | |||||||||
| NPI: | 1053799965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARPE | ||||||||
| FirstName: | SHEREE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9505 S STEELE ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984441858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535976800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9505 S STEELE ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984441858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535976800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 05/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 112708 | ZZ | N | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | ML60572504 | WA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 112708 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.