Healthcare Provider Details

I. General information

NPI: 1366092728
Provider Name (Legal Business Name): SHARPEVISION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 116TH AVE NE
BELLEVUE WA
98004-4623
US

IV. Provider business mailing address

2285 116TH AVE NE
BELLEVUE WA
98004-3015
US

V. Phone/Fax

Practice location:
  • Phone: 425-450-6990
  • Fax: 425-450-8807
Mailing address:
  • Phone: 425-426-2880
  • Fax: 425-450-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW R SHARPE
Title or Position: MEMBER
Credential: MD
Phone: 425-426-2880