1346483575 NPI number — ISOBELLE SHARON COE MA, ADM

Table of content: ISOBELLE SHARON COE MA, ADM (NPI 1346483575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346483575 NPI number — ISOBELLE SHARON COE MA, ADM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COE
Provider First Name:
ISOBELLE
Provider Middle Name:
SHARON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, ADM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COE
Provider Other First Name:
ISOBELLE
Provider Other Middle Name:
SHARON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, ADM
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1346483575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2960 TONGASS AVE
Provider Second Line Business Mailing Address:
BEHAVIORAL HEALTH - FIRST FLOOR
Provider Business Mailing Address City Name:
KETCHIKAN
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-228-4917
Provider Business Mailing Address Fax Number:
907-228-4920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2960 TONGASS AVE
Provider Second Line Business Practice Location Address:
BEHAVIORAL HEALTH - FIRST FLOOR
Provider Business Practice Location Address City Name:
KETCHIKAN
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-228-4917
Provider Business Practice Location Address Fax Number:
907-228-4920
Provider Enumeration Date:
04/17/2009

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: CDC ADM 3041 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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