Individual
DR. SHARON B SKIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T.
Contact information
Practice address
1109 N FOREST EDGE DR, SISTERS, OR 97759-2692
(907) 346-4096
(877) 319-7365
Mailing address
PO BOX 1475, SISTERS, OR 97759-1475
(907) 346-4096
(877) 319-7365
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10338
MA
225100000X
Physical Therapist
Primary
2623
OR
225100000X
Physical Therapist
783
AK
225100000X
Physical Therapist
PTL.0003243
CO
2251P0200X
Pediatric Physical Therapist
2623
OR
2251P0200X
Pediatric Physical Therapist
783
AK
2251P0200X
Pediatric Physical Therapist
PTL.0003243
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029669
—
AK
01
—
2623
OR BOARD OF PHYSICAL THERAPY
OR
05
—
500783631
—
OR
01
—
783
ALASKA BOARD OF PT AND OT
AK
01
—
PTL.0003243
CO DEPARTMENT OF REGULARTORY AGENCIES
CO
Enumeration date
09/21/2006
Last updated
06/22/2021
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