Healthcare Provider Details

I. General information

NPI: 1992684195
Provider Name (Legal Business Name): EMILY BETH SHERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 BROADWAY STE 301
TACOMA WA
98402-4454
US

IV. Provider business mailing address

8206 PRISTINE BEACH LN SE
PORT ORCHARD WA
98367-7929
US

V. Phone/Fax

Practice location:
  • Phone: 125-367-1990
  • Fax:
Mailing address:
  • Phone: 406-750-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: