1447223110 NPI number — SHARON I BARKER PA-C

Table of content: SHARON I BARKER PA-C (NPI 1447223110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447223110 NPI number — SHARON I BARKER PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARKER
Provider First Name:
SHARON
Provider Middle Name:
I
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447223110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1624 S I ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-5016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-274-4545
Provider Business Mailing Address Fax Number:
253-274-7993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2202 S CEDAR ST STE 330
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-2318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-503-2508
Provider Business Practice Location Address Fax Number:
253-404-0506
Provider Enumeration Date:
02/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  PA10004373 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA10004373 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0294333 . This is a "L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8355786 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0173947 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1010528 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0245894 . This is a "L & I" identifier . This identifiers is of the category "OTHER".
  • Identifier: G8908871 . This is a "MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00773464 . This is a "RAILROAD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: G8879295 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".




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