Individual
DR. JOHNATHAN AUGUST SHARRETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2076 S EAGLE RD, MERIDIAN, ID 83642
(208) 955-7334
(208) 955-7330
Mailing address
2076 S EAGLE RD, MERIDIAN, ID 83642
(208) 955-7334
(208) 955-7330
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60232338
WA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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