Healthcare Provider Details

I. General information

NPI: 1891687943
Provider Name (Legal Business Name): SHAREEMA BRYANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 RUCKER AVE APT 2
EVERETT WA
98201-5712
US

IV. Provider business mailing address

2421 RUCKER AVE APT 2
EVERETT WA
98201-5712
US

V. Phone/Fax

Practice location:
  • Phone: 425-263-2702
  • Fax:
Mailing address:
  • Phone: 425-263-2702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHCA.MC.70097460
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: