1750424636 NPI number — MRS. SHARI LYNN EINHORN DICKS MS PT

Table of content: MRS. SHARI LYNN EINHORN DICKS MS PT (NPI 1750424636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750424636 NPI number — MRS. SHARI LYNN EINHORN DICKS MS PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EINHORN DICKS
Provider First Name:
SHARI
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DICKS
Provider Other First Name:
SHARI
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSPT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1750424636
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1188 106TH AVE NE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98004-8614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-454-4864
Provider Business Mailing Address Fax Number:
425-646-3901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 BOREN AVE
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104-3595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-447-1570
Provider Business Practice Location Address Fax Number:
206-447-1592
Provider Enumeration Date:
02/14/2007

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: 225100000X , with the licence number:  PT00002943 , 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: 0004168 . This is a "L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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