Healthcare Provider Details
I. General information
NPI: 1164788279
Provider Name (Legal Business Name): SHARPEVISION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2012
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3025 112TH AVE NE STE 200
BELLEVUE WA
98004-8002
US
IV. Provider business mailing address
3025 112TH AVE NE STE 200
BELLEVUE WA
98004-8002
US
V. Phone/Fax
- Phone: 425-451-2020
- Fax: 425-450-9696
- Phone: 425-451-2020
- Fax: 425-450-9696
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0120X |
| Taxonomy | Cornea and External Diseases Specialist Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
R
SHARPE
Title or Position: MEMBER
Credential: MD
Phone: 425-426-2880