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General NPI Number Information
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NPI Number | 1063869014
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Entity Type | Individual
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Provider Name | SHARON LOUISE RUSH LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 521 EDWARDS ST
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City | MEDFORD
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State | OR
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Zip | 97501-5852
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Country | US
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Telephone | 541-646-7385
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Fax |
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Provider Business Mailing Address
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Address Line | 711 MEDFORD CTR # 334
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City | MEDFORD
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State | OR
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Zip | 97504-6772
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Country | US
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Telephone | 541-646-7385
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Fax | 541-732-4833
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | M6620
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License Number State | OR
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