Healthcare Provider Details

I. General information

NPI: 1801026463
Provider Name (Legal Business Name): SHARON LYNN CUSHING M.D. MSC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 07/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

PO BOX 5371
SEATTLE WA
98105-0371
US

V. Phone/Fax

Practice location:
  • Phone: 206-372-9053
  • Fax: 206-987-3925
Mailing address:
  • Phone: 206-372-9053
  • Fax: 206-987-3925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberTR 60094761
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberTR 60094761
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: