Individual
SHARON J. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
930 N BROADWAY, EVERETT, WA 98201-1585
(425) 317-0300
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 366-2983
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00151982
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30006683
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195595
LABOR & INDUSTRY
WA
01
—
42918U
REGENCE BLUESHIELD
WA
05
—
9643073
—
WA
Enumeration date
07/17/2006
Last updated
04/17/2015
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