Provider Demographics
NPI:1144218454
Name:LAWRENCE, SHARON M (DO)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:M
Other - Last Name:SOWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 N COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-1226
Mailing Address - Country:US
Mailing Address - Phone:503-366-6244
Mailing Address - Fax:503-366-6246
Practice Address - Street 1:525 N COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-1226
Practice Address - Country:US
Practice Address - Phone:503-366-6244
Practice Address - Fax:503-366-6246
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO150772207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500620165Medicaid
ORP01153153OtherRR MEDICARE PIN
ORR166804Medicare PIN