Individual
CHARLES SHARP SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3922 SE 49TH AVE, PORTLAND, OR 97206-3018
(920) 268-8867
Mailing address
3922 SE 49TH AVE, PORTLAND, OR 97206
(920) 268-8867
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
17903
OR
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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