Provider Demographics
NPI:1144376211
Name:SHARER, ROBERT ROLAND (CDP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ROLAND
Last Name:SHARER
Suffix:
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12009 SE 37TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1152
Mailing Address - Country:US
Mailing Address - Phone:425-641-3310
Mailing Address - Fax:
Practice Address - Street 1:909 SE EVERETT MALL WAY
Practice Address - Street 2:STE C364
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3746
Practice Address - Country:US
Practice Address - Phone:425-349-6240
Practice Address - Fax:425-349-6207
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)